Policy Details

4118.112 and 4218.112 FORM 1 Sexual Discrimination/Harassment

4118.112/4218.112
Form 1

Litchfield Public Schools
35 Wamogo Road ~ Litchfield, Connecticut ~ 06759

SEXUAL DISCRIMINATION / HARASSMENT COMPLAINT
LITCHFIELD PUBLIC SCHOOLS (Personnel)

Name of the complainant

Date of the complaint Date(s) of alleged harassment

Name or names of the alleged harasser(s)



Location(s) where alleged harassment occurred






Name(s) of any witness(es) to the alleged harassment



Detailed statement of the circumstances constituting the alleged discrimination or harassment


Remedy Requested

Litchfield Board of Education
Form Developed: 1/22/2019
Form Revised: 1/14/2021

Download a PDF of this form.