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EXTERNAL COMPLAINTS OF DISCRIMINATION PART I COMPLAINANT INFORMATION (Print all items legibly.) Name Street Address/P.O. Telephone Email AddressCityStateZip Depart II CAUSE OF DISCRIMINATION OR COMPLAINT
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How to fill out program discrimination complaint form

01
Obtain a program discrimination complaint form from the appropriate organization or agency.
02
Fill out your personal information, including name, contact information, and any other relevant details.
03
Clearly state the nature of the discrimination you have experienced, providing specific examples and details.
04
Include any supporting documentation or evidence that you have to support your claim.
05
Submit the completed form to the relevant organization or agency as per their instructions.

Who needs program discrimination complaint form?

01
Anyone who believes they have experienced discrimination in a program or service provided by an organization or agency would need a program discrimination complaint form to formally file a complaint.
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The program discrimination complaint form is a document used to report instances of discrimination in a specific program or activity.
Anyone who believes they have been discriminated against in a program or activity is required to file a program discrimination complaint form.
To fill out the program discrimination complaint form, you need to provide your contact information, details of the discrimination incident, and any supporting evidence.
The purpose of the program discrimination complaint form is to address and investigate instances of discrimination in programs or activities to ensure equal access and treatment for all individuals.
The program discrimination complaint form must include details of the discrimination incident, names of individuals involved, date and location of the incident, and any supporting evidence.
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