PDFWAC 132U-300-140
Other discrimination complaint options.
Discrimination complaints may also be filed with the following federal and state agencies:
Washington State Human Rights Commission at http://www.hum.wa.gov/
U.S. Dept. of Education Office for Civil Rights at http://www2.ed.gov/about/offices/list/ocr/index.html
Equal Employment Opportunity Commission at http://www.eeoc.gov/
Discrimination/Harassment Complaint Form | |
This form is designed to assist you with filing a discrimination and/or harassment complaint. Please write clearly and focus on the alleged discriminatory and/or harassing conduct. The complaint should include as much information regarding the incident giving rise to the complaint as possible, including the location, date and time of the alleged incident(s); the name of the individual or group whom the complaint is against, if known; a description of the incident(s); and the remedy sought. | |
Name of person filing the complaint: _____ | Date: _____ |
Signature: _____ | Date: _____ |
You may use the back side of this sheet if needed. Please return this form to the Title IX/EEO coordinator, LDC 235. | |
[Statutory Authority: Chapter 28B.50 RCW. WSR 18-17-025, § 132U-300-140, filed 8/6/18, effective 9/6/18.]