Itasca ISD - Title IX Complaint Form
Please submit as much information as possible. The Title IX Coordinator or designee will contact you for more information. Information may also be submitted to Allison Middleton, Title IX Coordinator at 254-687-2922 ext. 150 or amiddleton@itascaisd.net.
Email address *
Name *
Contact Information (phone/email) *
Date of incident *
MM
/
DD
/
YYYY
Location of incident *
Summary of alleged events, including names of victim(s) and harasser(s) . *
A copy of your responses will be emailed to the address you provided.
Submit
Never submit passwords through Google Forms.
reCAPTCHA
This form was created inside of Itasca ISD. Report Abuse