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LACYD Harassment Complaint Form
For more information about harassment prohibited by LACYD, please read our full policy at
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Your name (optional):
Please note: if an anonymous claim is submitted, the person about whom the claim is filed is only subject to Tier 2 disciplinary action. You can read our full policy at
Name of LACYD Member(s) about whom this claim is filed:
Name(s) of any witnesses:
Please describe the incident in as much detail as you are comfortable sharing:
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