Uniform Complaint Form

The Uniform Complaint Procedures (UCP) process may be used for complaints alleging non-compliance of state and federal laws governing educational programs or discrimination. Not all complaints are within the scope of the UCP, even if they involved alleged violations of law. Therefore, please refer to the Annual Notice to determine if your complaint meets the description of a UCP. Complaints shall be filed no later than one year from the date the alleged violation occurred.

This form will be submitted to the Compliance Officer/Title IX Coordinator.

Please complete all information.
If you need assistance completing the form, please call 559 258-0800.

(DO NOT USE FOR WILLIAMS 35186 COMPLAINTS)

Complaints may be filed anonymously. However, if you wish to receive a response to your complaint, you must indicate that a response is required and provide contact information. Do you wish to receive a response to your complaint?*

YesNo

Full Name

First NameLast Name

Phone Number

Please enter a valid phone number.

Email

example@example.com

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

THIS COMPLAINT IS FILED ON BEHALF OF:

Rows	Student's Legal Name	School of Attendance	SSID #
My Child

Rows	Name of Agency	Address	Name and Position
Agency

Other:

School Name*

Date*

Date

Location*

Please describe the complaint in detail:*

Signature*

Uniform Complaint Form

Complainant Information

Complaint Details