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Title VI Complaint Form Please complete this form to the best of your ability. If you need translation or other assistance, contact. Name Address City Zip Phone: Homework Mobile Email: Basis of Complaint
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A Title VI complaint is a formal grievance filed by individuals who believe they have been subjected to discrimination on the basis of race, color, or national origin in programs or activities receiving federal financial assistance.
Any individual or group who believes they have been discriminated against under Title VI of the Civil Rights Act of 1964 may file a complaint.
To fill out a Title VI complaint, individuals should provide detailed information about the incident, including their personal information, the nature of the discrimination, and any relevant dates and witnesses.
The purpose of a Title VI complaint is to ensure that individuals have a recourse for addressing grievances related to discrimination in federally funded programs and to promote compliance with civil rights laws.
The complaint must include the complainant's contact information, details of the discriminatory action, the parties involved, and any witnesses, along with the date and location of the incident.
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