Complaint Form

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Complaint Form

Any student, employee, or community member who believes that they have experienced or witnessed discrimination or harassment may make a complaint by completing this form which is submitted directly to the DPS Discrimination Prevention and Response Coordinator.

Students and DPS employees are encouraged to make a report internally directly to their school's Discrimination Prevention and Response Designee, principal, trusted adult (students), or their HR Partner (employees). Parents and community members are also encouraged to report directly to the school or department where the harassment or discrimination took place or to the Office of Family and Community Engagement at 720-423-3054.

Email *

First Name of Complainant (the person believed to have EXPERIENCED the harassment or discrimination): *

Last Name of Complainant: *

How would you describe the Complainant? *

Student

DPS Employee

Parent, guardian, or other party living in the home

Community member

Other:

First Name of the Respondent (the person believed to have perpetrated the harassment or discrimination): *

Last Name of the Respondent: *

How would you describe the Respondent?

Student

DPS Employee

Parent, guardian, or other party living in the home

Community member

Other:

Clear selection

Date that the incident took place: *

YYYY

Location where the incident took place: *

Does the alleged conduct relate to the complainant belonging to any of the following protected classes or any of the following types of potential discrimination? If so, select the applicable option below. *

Race

Color

Gender

Sexual orientation

Gender identity or expression

Transgender status

Religion

National origin

Immigration/citizenship status

Ancestry

Age

Marital status

Pregnancy status

Veteran status

Disability

Genetic information of an employee

Participation in a discrimination investigation

None of the above

Required

Please provide a description of the incident in as much detail possible:

Have you already reported this concern to a DPS employee? *

Yes

If yes, please note the name(s) of the person to whom you reported and what follow up took place.

What is your first name? *

What is your last name? *

What is your student or DPS employee ID number (if applicable)?

What is your email address? *

What is your phone number? *

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

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