|
Section
|
(4000) Personnel
|
|
Policy Name
|
Regulation: Conduct and Discipline-Employee Discipline
|
|
Policy Number
|
4410.1 REG
|
The below form shall be used for any complaints of improper conduct that align with Policy 4410, other than sexual harassment or sexual discrimination, which is defined in Board Policy 4420, Prohibition of Sex Discrimination and Sexual Harassment (Personnel).
COMPLAINT FORM REGARDING IMPROPER CONDUCT OTHER THAN SEXUAL HARASSMENT OR SEXUAL DISCRIMINATION (PERSONNEL)
This complaint form should be used for complaints of improper conduct that aligns with Policy 4410, other than sexual harassment or sexual discrimination as defined in the Board’s Administrative Regulations regarding the Prohibition of Sex Discrimination and Sexual Harassment (Personnel) Policy 4420
Name of the complainant _________________________________________________
Date of the complaint ____________________________________________________
Date of the alleged improper conduct _______________________________________
Name or names of the perpetrator(s) ________________________________________
______________________________________________________________________
Location where such improper conduct occurred _______________________________
______________________________________________________________________
Name(s) of any witness(es) to the improper conduct
______________________________________________________________________
Detailed statement of the circumstances constituting the alleged improper conduct
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
Remedy requested______________________________________________________________
______________________________________________________________________
Signature of Complainant: ________________________________________________