Last Name First Name MI
Best time to call:
State Zip Code
Currently a CR Student?
Was Early Resolution sought?
If yes, with whom: Date
Indicate the type(s) of complaint being filed:
Sexual Misconduct Dating Violence Domestic Violence Stalking
If you are filing a Discrimination or Harassment complaint, indicate the protected status(es) that was/were the basis(es) of the alleged
Discrimination or Harassment. (Please select all that apply):
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Redwoods Community College District provides a procedure for filing and processing complaints of unlawful discrimination and
harassment. These policies and procedures incorporate the legal principles contained in nondiscrimination provisions of the
California Code of Regulations, title 5, sections 59300 et seq. as well as other state and federal substantive and procedural
Please complete this form to the best of your ability. Once completed please click on "Submit" and this form will automatically
be emailed to Wendy Bates, Title IX Coordinator. You will receive a response within 48 hours. You can also mail the form to:
College of the Redwoods, Attn: Wendy Bates, Title IX Coordinator, 7351 Tompkins Hill Road, Eureka, CA, 95501.
Student ID Number: ____________