Series 405.7.6.4P - Follow-up Report on Complaint of Harassment, Discrimination, Violence or Hazing
Adopted: August 1993
Revised: November 2016
To: Human Rights Officer:
Director of Human Resources (concerns relating to personnel conduct)
Director of Elementary Education (concerns relating to student conduct, grades K-5)
Director of Secondary Education (concerns relating to student conduct, grades 6-12)
Director of Special Education (concerns relating to a student’s disability, including their rights under Section 504)
From: , Principal/Designee/other (circle one)
____________________________________________ , _______________________________
Position School
Date:______________________________
Subject: Fifteen-Day Follow-Up Report on Complaint of Harassment, Discrimination, Violence or Hazing
Approximately 15 days ago I completed the investigation of a complaint based on
(check all that apply):
□ race □ national origin □ marital status
□ religion □ sex □ creed
□ sexual orientation □ age □ disability
□ color □ hazing (of a student) □ familial status
□ status with regard to public assistance □ genetic information
□ membership or activity in a local human rights commission
harassment, discrimination, violence or hazing from
(student/district personnel) in which I found that the complaint was substantiated.
(circle one)
I have checked with the complainant to determine if the harassment, discrimination, violence or hazing has ceased or if it continues. He or she reports that it has: ceased continues
I would also like to inform you that
Signature of Investigator X Date
Signature of Complainant X Date
Procedure/405.7.6.4P/11-21-16