Bricolage Disability Discrimination Complaint Form
You do not have to use this form to file a complaint. You may send a letter or email instead of this form, however the letter or email must include the information identified in this form.
All complaints are received and reviewed by Channing Cornelius, Director of Special Education. Mr. Cornelius can be reached via the following: 3368 Esplanade Ave., New Orleans, LA 70119; (504) 539-4505; ccornelius@bricolagenola.org
Name Of Person Filing Complaint *
Your answer
Address *
Your answer
Email Address *
Your answer
Telephone Number *
Your answer
Relationship To Student *
Name Of Person Discriminated Against *
Your answer
Nature Of The Complaint (please be as detailed as possible) *
Your answer
Has school administration been made aware of the concern? *
If yes, what action has been taken by Bricolage? *
Your answer
Please detail what you are seeking as a resolution. *
Your answer
Additional Comments *
Your answer
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