Goddard USD 265 Harassment Electronic Complaint Form

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Complaints of discrimination or discriminatory harassment by an employee should be addressed to the employee’s supervisor, the building principal, or the district compliance coordinator. Complaints by a student should be addressed to the building principal, another administrator, the guidance counselor, or another certified staff member. Any school employee who receives a complaint of discrimination or harassment from a student shall inform the student of the employee’s obligation to report the complaint and any proposed resolution of the complaint to the building principal. If the building principal is the alleged harasser, the complaint shall be reported to the district compliance coordinator. Complaints by any other person alleging discrimination should be addressed to the building principal or the district compliance coordinator. The identity of the individual filing a complaint will be kept confidential to the extent possible without compromising a thorough investigation.

Please see the Complaints and Procedures below to file an informal and formal complaint at goddardusd.com/page/55160_4.

Please fill out the Goddard Harassment Electronic Complaint Form Below

Email *

Your Name *

School or Department *

Amelia Earhart Elementary

Apollo Elementary

Clark Davidson Elementary

Explorer Elementary

Oak Street

Challenger Intermediate

Discovery Intermediate

Eisenhower Middle

Goddard Middle

Eisenhower High

Goddard High

Goddard Academy / Virtual School

Transportation

Maintenance or Grounds

Central Administration Center

Required

Type of Complaint *

Sexual

Disability

Racial

Other:

Please describe the specific incidents that you feel constitute harassment. *

What is/are the date/s the incident occurred?
*

Please describe the incident including what occurred, when it occurred, and whether there were any witnesses other than you to the event(s).
*

Other than the individual(s) you have identified above, is/are there any other person(s) who you feel should be contacted in connection with the investigation of this complaint. If so, please identify the individuals, how to contact them, and what information these individual(s) may have.
*

This form will be filed with the USD 265 / Goddard Public Schools District Compliance Coordinator, 201 S. Main, Goddard, Kansas 67052, 316-794-4000. Your complaint of harassment will be promptly and thoroughly investigated. The investigation will be kept confidential to the extent as possible with the Districts need to fully investigate and address the situation. If the investigation verifies that inappropriate behavior has occurred, appropriate disciplinary action will be taken against the person who has harassed you. If at any time you feel that as a result of your complaint you are being retaliated against, please file an additional complaint using this form or contact the Districts Compliance Coordinator. He can be contacted at 201 South Main, Goddard, KS 67052 or by telephone at 316-794-4000.

Please read the above carefully before signing. Your electronic signature below will indicate that this form accurately and completely describes your complaint of harassment.

Electronic Signature (Please type your name here)
*

Date *

YYYY

A copy of your responses will be emailed to the address you provided.

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