102-E6 - Equal Educational Opportunity - Disposition of Complaint Form

Date:

 

Date of initial complaint:

 

Name of Complainant (include whether the Complainant is a student or employee):

 

Date and place of alleged incident(s):

 

Name of Respondent (include whether the Respondent is a student or employee):

 

 

Nature of discrimination alleged (check all that apply):

 

 

Race

 

Religion

 

Color

 

Sexual Orientation

 

National Origin

 

Age

 

Sex

 

Actual or potential parental, family or marital

status

 

Disability

 

Pregnancy or related conditions

 

Creed

   

 

Summary of Investigation: _______________________________________________________________

_____________________________________________________________________________________

_____________________________________________________________________________________

_____________________________________________________________________________________

_____________________________________________________________________________________

_____________________________________________________________________________________

_____________________________________________________________________________________

 

I agree that all of the information on this form is accurate and true to the best of my knowledge.

 

Signature: _____________________________________ Date: _________________________

 

Approved: April 13, 2026

Reviewed: April 13, 2026

Revised: April 13, 2026