Title VI (Civil Rights Act) Complaint
Title VI of the Civil Rights Act of 1964 states “No person in the United States of America shall, on the ground of race, color, or national origin, be excluded from participation in, be denied the benefits of, or be subjected to discrimination under any program or activity receiving federal financial assistance.”
Please provide the following information necessary in order to process your complaint. Assistance is available upon request by calling the Title VI Coordinator at (559) 621-7433 or dial 711 California Relay Service.
Fields marked with an asterisk (*) are required. If you wish to send attachments, you may include them at the end of this form.
Person Allegedly Discriminated Against (If other than the complainant)
Witnesses (Please provide the contact information for any witness to the incident)