Title IX Incident Report Form

Title IX of the Education Amendment of 1972 states that, “No person in the United States shall, on the basis of sex, be excluded from participation in, be denied the benefits of, or be subjected to discrimination under any program or activity receiving Federal financial assistance.”

In accordance with Title IX, Crossover Preparatory Academy prohibits discrimination in services or benefits offered by the school based upon sex.

Likewise sexual harassment, as form of gender discrimination, is prohibited under Title IX and school policy.

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Name of reporter (or leave blank for anonymous)
Contact info so that the Title IX Investigator can follow up with questions (leave blank for anonymous)
Description of incident (include specifics such as dates, times, locations, and witnesses)
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