Title IX Anonymous Report Form
You may submit an anonymous and confidential report of sex discrimination, including sexual harassment or sexual violence, by using this form. Fill in the information requested below, to the best of your ability, and click the blue SUBMIT button when you are finished. This information will be received confidentially by the District’s Title IX Coordinator, John DiPaolo. Mr. DiPaolo serves as the Interim District Compliance Officer for PAUSD, and his duties include reviewing and coordinating the District’s duty to address reports and complaints under Title IX. He is the responsible employee to handle reports or complaints regarding unlawful discrimination, including sexual harassment and sexual violence. You may contact him via email at complianceofficer@pausd.org or via phone at (650) 833-4262.

Once the District Compliance Officer receives your anonymous report, he will start an investigation and contact you within 10 days if you have requested to be contacted and if you have provided your contact information in the form below. If you have chosen not to provide your identity or contact information, the District Compliance Officer will review the information you submitted and determine the available next steps in order to address the matter.

The form below collects information on incidences of sexual assault, sexual harassment, dating/interpersonal relationship violence, or stalking. Anonymous reports are used to gather information about these incidents at PAUSD, and compiled data are used to inform the community about our campus climate. As mentioned above, you may *optionally* provide an email address or telephone number if you would like the District Compliance Officer to contact you. Your submission will be stored in a password protected system only accessible by the District Compliance Officer and other District personnel approved by the District Compliance Officer for any subsequent investigation.

If you would like to speak confidentially to the District Compliance Officer now, please call 650-833-4262.
Affiliation with the Incident:
Nature of the allegation (check all that apply):
Have you made any previous reports about this incident to anyone at PAUSD?
The following questions ask about the incident(s) that you are reporting. If any information is unknown, please leave the question blank.
Date of incident:
MM
/
DD
/
YYYY
Approximate time of incident:
Time
:
Victim/Survivor's gender:
Victim/Survivor's age:
Your answer
School where Victim/Survivor was enrolled:
Your answer
Victim/Survivor's affiliation with PAUSD:
Is there ongoing abuse?
Is drugging of the Victim/Survivor suspected?
Alleged Perpetrator's gender:
Alleged Perpetrator's Age:
Your answer
Alleged Perpetrator's affiliation with PAUSD?
Relationship of Victim/Survivor and alleged Perpetrator:
Location of incident:
Did the incident occur at a PAUSD sponsored event or at a school district activity off campus?
[Optional] If you wish, you may provide the name of the alleged perpetrator:
Your answer
Would you like the Title IX Coordinator to contact you?
[Optional] If you answered yes above, please provide a phone number or email address at which you may be reached.
Your answer
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