Title IX Formal Complaint Form

The Ascent Classical Academies takes reports made through this site seriously. Please make your report as accurate, complete, and truthful as possible. Every effort will be made to evaluate your report promptly, however, the timing and manner in which the Ascent Classical Academies responds to the report will vary depending on the information provided and whether you wish to remain anonymous. The school's code of conduct prohibits knowingly making false statements or knowingly submitting false information during the grieving process. Please note that every effort will be made to keep information confidential to the extent possible. If this cannot be done, please know that the information will only be shared on a need-to-know basis. Additionally, this report may become part of Ascent Classical Academy's administrative record keeping and therefore may be available to the students to which it pertains under the Family Educational Rights and Privacy Act (FERPA). FERPA is a federal act that protects the privacy of student education records.

Name (Leave Blank if Anonymous)

Date you learned of incident

Complainants Email Address (Optional)

Involved Individuals, Organizations or Groups

Please list the individuals, organizations, and/or groups involved in this incident, including as many of the listed fields as you can provide.

Name of Individual or Organization(Required)

Role(Required)

Phone

Email

Name of Individual or Organization (Optional)

Role

Phone

Email

Name of Individual or Organization (Optional)

Role

Phone

Email

Name of Individual or Organization (Optional)

Role

Phone

Email

Please provide information about your experience and/or observations.

Where did this incident take place? If the behaviors occurred in more than one location, please select the location where the conduct began and provide further details about additional locations in the space provided for the description of the incident.(Required)

Please provide the specific address, if available.

Please provide a description of the incident using concise and objective language. If you have a desired outcome, please include details here.(Required)

Please describe the atmosphere prior to the incident and the impact that this incident may have on the learning and/or workplace environment. If you do not feel there is an impact to the learning and/or workplace environment, you may leave this blank.

Please provide the police report number, if applicable and available. if the police were involved but you do not know the report number, please enter 'police involved but I do not know the report number.' If the police were not involved, please enter N/A, in the space below.

Please remember that the timing and manner in which Ascent Classical Academies addresses this report will vary depending on the information provided and whether involved parties are available for further discussion.

You may contact me

To the extent possible, I would like to remain anonymous to involved individuals, but you may contact me

Please do not contact me

Please list your phone number or email address, in the event that we need to contact you. If you have filed this report anonymously or do not want to be contacted, please enter "do not contact me" in the space below.(Required)

Supporting Documentation

Please attach supporting templates and documents. Examples may include: photos, emails or video clips)

Drop files here or

Max. file size: 10 MB.

Title IX Formal Complaint Form