Employee Title IX Formal Complaint Form

Employee Title IX Formal Complaint Form

Employee Title IX Contact
Lakieshia Barnett (Employees)
Director of Human Resources
Email: lbarnett@suscc.edu
Name:

First NameLast Name
Employee ID Number:
A Number (Ex, A012345678)
Phone Number:
Please enter a valid phone number.Format: (000) 000-0000.
Email:
example@example.com
Address:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Your relationship to the college:
Respondent Name:

First NameLast Name
Respondent Relationship to You:
Date of Event:

MonthDayYear
Date
Time of Event:
Example, 8:00 AM
Campus:
Building:
Room:
Describe the Alleged Incident:
How would you want the Situation Resolved:
Signature
Please verify that you are human
Should be Empty: