Harassment / Discrimination Complaint Submission Form (Electronic Version)

Home > Harassment / Discrimination Complaint Submission Form (Electronic Version)

The Office of Equality & Civil Rights is tasked with working collaboratively in enforcing non-discrimination and equal treatment for all our students, employees, parents and other stakeholders. You may use this form to report incidents of possible discrimination or harassment. For a printable version of the complaint form, please see the Resources section.

*(Required fields displayed in red with asterisks)

Full name:

Contacting party is:

Student's name:

Job title (If MPS staff):

Place of employment/school:

Supervisor/Principal:

Primary phone number:

Email:

Mailing address (street, city, state, zip):

Gender:

Race/Ethnicity:

Date(s) of Alleged Incident:

Type of complaint:

I feel that I was discriminated/sexually harassed or assaulted/retaliated against as follows:

* denotes a required field

Submit