Complaint procedures for Office of Civil rights The Office for Civil Rights is responsible for enforcing Title VI of the Civil Rights Act of 1964, 42 U.S.C. 2000d et seq., Title IX of the Education Amendments of 1972, 20 U.S.C. 1681 et seq., Section 504 of the Rehabilitation Act of 1973, as amended, 29 U.S.C. 794 and the Age Discrimination Act of 1975, 42 U.S.C. 6101 et seq., implemented at 45 C.F.R. Part 90, which prohibit discrimination on the bases of race, color national origin, sex, handicap and age, respectively, in educational programs and activities receiving or benefiting from Federal financial assistance from the U. S. Department of Education. If you believe the matter you are complaining about is covered by our regulations and wish to file a complaint, you may fill out the enclosed discrimination form or write us a letter. The letter should include the following information: 1) your name, address, and telephone number; 2) the basis (race, color, national origin, age, sex, handicap) of the alleged discrimination; 3) the name(s) and address(es) of the institution(s) you believe have discriminated against you; 4) the approximate date(s) of the discriminatory act(s); 5) a detailed description of the alleged discriminatory act(s) including any supporting documents; 6) the name of any other Federal, state or local civil rights agency or any Federal or state court with which you intend to file this complaint; and, 7) if applicable, the status of your complaint within the internal grievance procedures of the institution. Please be sure that your original signature is on the complaint form. Page 2 There are two laws governing personal information submitted to Federal agencies such as OCR: The Privacy Act of 1974 (5 U S C #552a), and the Freedom of Information Act (5 U S C #552). Enclosed is a notice about investigatory uses of personal information, which briefly describes these laws Please read this notice, sign all forms, returning one copy to OCR and keeping one for your information We also wish to make you aware that, in general, OCR only processes complaints which have been filed within 180 calendar days of the last alleged act of discrimination or within 60 days after the completion of an internal grievance procedure Therefore, if you feel that your allegations of discrimination may be untimely and you wish to request a waiver of the 180-day filing limitation, you should indicate in writing the specific reasons for the delay in filing your complaint we will notify you whether your request for a waiver has been granted * If we may be of any further assistance, please contact Neil Green, Equal Opportunity Specialist, at (617) 223-9692 Sincerely, Carolyn F Lazaris Director Program Review and Management Support Staff Enclosures *Waivers normally are granted only for one or more of the following reasons - the complainant could not reasonably be expected to know within 180 days of its occurrence that the treatment was discriminatory; the complaint, however, must be filed within 60 days of learning that the act was possibly discriminatory; there was an illness or other incapacitating circumstances which precluded filing within 180 days; or - there was no action taken by another federal, state, or local civil rights enforcement agency with whom a similar complaint was filed. Your written waiver request must address one of these areas in order to be granted. Waivers for any other reasons are only at the discretion of the OCR Regional Director and for sufficient cause. We will review your request and let you know whether there are adequate grounds to waive the filing tim elines. DEPARTMENT OF EDUCATION OFF I CE FOR CI V I L RIGHTS DISCRIMINATIONS COMPLAINT FORM Complainant: Address: City, State, and Zip Code: Telephone Number: (Area Code ) (home) ( Area Code ) ( Business) Person Discriminated Against ( if other than complainant ): Address: City, State, and Zip Code: Telephone Number: __ ( Area Code ) Institution which you believe has discriminated: Name: Address: City , State, and Zip Code: Telephone Number: (Area Code) Injured Party was discriminated against because of ( check one or more ): Race or Color National Origin Sex Handicap Age When d id the discrimination occur? ( Date) Page 2 Describe the discrimination: (Use additional sheets if necessary) Have efforts been made to resolve this complaint through the institution's internal grievance procedure? Yes / / No / If "yes" what is the status of the grievance? Has this complaint been filed with this agency or any other Federal, State, or local civil rights agency or court? Yes / / No / / Agency or Court: Contact Person: Address: City, State, and Zip Code: Telephone Number: Date filed: (Area Code) Page 3 Do you intend to file with another agency or court? Yes / / No / / Agency or Court: Address: Telephone Number: (Area Code) Date when you intend to file: Have you (or the person discriminated against filed any other complaints with this agency)? Yes / / No / / Against whom were they filed? Name and address: City, State, and Zip Code: Telephone Number: (Area Code) Date of Filing: Briefly, what was the complaint about? What was the result? Signature Date