Complaint and/or Request for Investigation
Please fill out the following form to be delivered to Roots Compliance Officer (Director of Student Services).  
No district employee or student shall be subjected to discrimination in employment or any district program or activity on the basis of age, color, disability, gender, gender identity, genetic information, national origin, pregnancy, race, religion, sexual orientation, or veteran status. Roots is committed to providing equal access and equal opportunity in its programs, services and employment including its policies, complaint processes, program accessibility, district facility use, accommodations and other Equal Employment Opportunity matters. Roots Director of Student Services has been designated to handle inquiries and complaints regarding unlawful discrimination, harassment, and retaliation: 
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Name *
Address *
Telephone *
Email Address *
What is your preferred form of communication? *
I am a: *
Type of request: *
If you are filing a discrimination or harassment compliant, please check the protected categories that apply to you. *
Please describe your concern or complaint in detail, including the date the problem occurred. *
Provide the name(s) of the individual(s) you wish to file the complaint against, and their position and contact information, if known.  *
Required Signatures
Typing your name in the following box will be considered signing this document. 
I state that the foregoing information is true and correct, and I understand that there will be consequences for intentionally providing false information. 
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