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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.