6. Do you have any documents that support your allegation? (Please list and attach a copy.)
7. Describe how you would like the complaint to be resolved. Be as specific as possible.
8. If you are to be represented, provide the name, address, and telephone number of your representative.
To the best of my knowledge, the information I have submitted is accurate. I am aware that an informal process is available
to resolve the complaint, and feel that a formal complaint is appropriate to resolve the discrimination and harassment I
allege in this complaint. I understand that I may have rights to relief under the state and federal laws, and that filing a
formal complaint does not necessarily affect the time within which I must file a complaint with the agencies or courts that
enforce those laws. I understand that if I am a member of a collective bargaining unit, I may have rights to grieve the
actions in my complaint, and that filing this complaint does not substitute for that process or give me more time to grieve
any of those actions. I agree to cooperate within reason with any investigation conducted by the college into this matter.
Please return this completed form to the Human Resources Office, located at 43-500 Monterey Ave., Palm Desert,
If you have any questions, please contact the Human Resources Department at 760-773-2529.