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Hayward USD |  E  5145.7  Students

Sexual Harassment   

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A complaint can be submitted in writing or via email, it does not have to be on an official form.

HAYWARD UNIFIED SCHOOL DISTRICT SEXUAL HARASSMENT REPORT FORM

TO: Principal

FROM: Name/School/Department

1. Identify the respondent(s) against whom your complaint is made.

2. Describe the incident(s), or events(s), date(s), time(s) and locations that led to your complaint.

3. Give specific examples of offensive conduct. (If more space is required, please attach additional pages).

4. Do you have any physical evidence (pictures, videos, texts, notes, etc) that support your complaint?

5. What did you or others do to try to resolve the issue? What was the outcome?

6. What remedy are you seeking?

Your signature: Date:

Board Policy Reference: 5145.7

Exhibit HAYWARD UNIFIED SCHOOL DISTRICT

version: July 6, 1993 Hayward, California

revised: November 13, 2013

revised: May 8, 2019