Select Page

JII-EA STUDENT CONCERNS, COMPLAINTS, AND GRIEVANCES

JII-EA STUDENT CONCERNS, COMPLAINTS, AND GRIEVANCES

If you are a student who feels that ASDB has taken one or more of the following actions, please let ASDB know using this form: 1. violated constitutional rights 2. denied an equal opportunity to participate in any program or activity for which the student qualifies not related to the student's individual capabilities 3. discriminatory treatment on the basis of race, color, religion, sex, age, national origin or disability 4. concern for the student's personal safety Parents/Guardians may file this on the student's behalf. Your complaint will be forwarded to the ASDB Complaints Officer.

  • MM slash DD slash YYYY
  • I wish to complain against:

  • MM slash DD slash YYYY
  • Indicate what you think can and should be done to solve the problem. Be as specific as possible.
  • Please type in your name for your electronic signature
  • MM slash DD slash YYYY
  • Max. file size: 256 MB.

JICK-EA STUDENT VIOLENCE / HARASSMENT / INTIMIDATION / BULLYING

JICK-EA STUDENT VIOLENCE / HARASSMENT / INTIMIDATION / BULLYING

If you are a student who feels that you are a victim of harassment, bullying, intimidation or violence, please let ASDB know using this form. This complaint process only applies when the alleged harasser is another student. (Parents/Guardians may file this on the student's behalf.) Your complaint will be forwarded to the ASDB Complaints Officer.

  • MM slash DD slash YYYY
  • Report Information:

  • Be as specific as possible
  • MM slash DD slash YYYY
  • Please type in your name for your electronic signature
  • Max. file size: 256 MB.

JBB-E SEXUAL HARASSMENT (Students)

JBB-E SEXUAL HARASSMENT (Students)

If you are a student who feels that you are a victim of sexual harassment, please let ASDB know using this form. This complaint process applies whether the alleged harasser is another student, a staff member, or a third party. (Parents/Guardians may file this on the student's behalf.) Your complaint will be forwarded to the ASDB Complaints Officer.

  • Reporter’s Information

  • MM slash DD slash YYYY
  • Offender’s Information

  • Witnesses

  • Reporter’s Attempts to address the Alleged Actions of Perpetrator

  • If yes, list the name, job title, work location, telephone number of the student(s) (if you know).
  • Proposed Resolution of Situation

  • Additional Information or Comments

  • MM slash DD slash YYYY
  • Please type in your name for your electronic signature
  • Max. file size: 256 MB.

JB-E EQUAL EDUCATIONAL OPPORTUNITIES

JB-E EQUAL EDUCATIONAL OPPORTUNITIES

If you are a student and you feel that you are unable to participate fully in classroom instruction because of race, color, religion, sex, sexual orientation, gender identity, age, national origin, or disability, please let ASDB know using this form. (Parents/Guardians may file this on the student's behalf.) Your complaint will be forwarded to the ASDB Complaints Officer.

  • MM slash DD slash YYYY
  • I wish to complain against:

  • MM slash DD slash YYYY
  • Indicate what you think can and should be done to solve the problem. Be as specific as possible.
  • Please type in your name for your electronic signature
  • Max. file size: 256 MB.

ACA-E SEXUAL HARASSMENT

ACA-E SEXUAL HARASSMENT

If you are a staff member who feels that you are a victim of workplace harassment, please let ASDB know using this form. This complaint process applies whether the alleged harasser is another staff member, a student, or a third party. Your complaint will be forwarded to the Human Resources Office.

  • MM slash DD slash YYYY
  • If yes, list the name, job title, work location, telephone number of any person to whom you described the incident(s); the date or approximate date you brought the incident to the other individual’s attention.
  • If yes, list the name, job title, work location, telephone number of the employee(s).
  • I certify that this information is true and correct to the best of my knowledge. I am willing to cooperate fully in the investigation of my complaint and to provide whtever evidence ASDB deems relevant. I understand that in order to investigate my complaint, it will be necessary to interview you, the alleged harasser(s), and any witnesses with knowledge of the allegations or defenses. I further understand that ASDB will notify all persons and witnesses involved in the investigation that it is confidential and that unauthorized disclosures of information concerning the investigation could result in disciplinary action up to and including discharge from employment.

  • Please type in your name for your electronic signature
  • MM slash DD slash YYYY
  • Max. file size: 256 MB.