Instructions for filling out this form: If you believe that you have been the victim of sexual harassment, please fill out this form, sign where indicated below, and submit it by hand delivery, electronic mail, or U.S. mail to the District Title IX Coordinator using the contact information listed on the District website. 

This formal complaint form is intended for use by the alleged victim of Title IX sexual harassment (referred to in Title IX Regulations as the “Complainant”). Under Title IX and the Family Educational Rights and Privacy Act (FERPA), a parent or legal guardian may sign a complaint form and otherwise act on behalf of a minor in the formal complaint process. 

If you are not filling this form out as a parent or guardian and you wish to report sexual harassment against another person in the District’s education program or activities, please report your concerns to the District’s Title IX Coordinator so that the District can take further action. Under federal law, only a current student or employee; a person who is currently participating or attempting to participate in Bullitt County Public Schools' education programs or activities; or the parent, guardian or authorized legal representative who has a legal right to act on behalf of a current student, employee, or participant in Bullitt County Public Schools' education programs or activities may use the formal complaint process to initiate an investigation. The District will process all formal complaints in accordance with the requirements of Title IX and its applicable regulations.