Durham Technical Community College
1637 Lawson Street /
Durham, North Carolina 27703
-536-7200 durhamtech.edu
Sexual Misconduct Complaint Form
Durham Tech is fully committed to providing programs, activities, and an educational
environment free from sexual discrimination. Should an employee or student feel his/her
rights under Title IX have been violated, he/she may use this form to submit an illegal
dis
crimination or sexual misconduct. Complaints may be emailed to Angela Davis, the Title
IX Coordinator at davisa@durhamtech.edu or delivered to ERC (Building 5), room 5-213.
You may also contact her directly at 919-536-7250, ext. 6002 if you need assistance.
PROVIDE ALL AVAILABLE INFORMATION
Contact Information
N
ame: ________________________________
Department: ___________________________
Office Phone: ________________________
Title: _______________________________
Email Address: ______________________
Home/Cell Phone ____________________
Classification (Faculty, Non-Faculty, Student, Other) ________________________________
Complaint Information
(Please provide the following information about the individual(s) you believe committed
sexual misconduct, harassed, or retaliated against you. If you do not have all of the
information, you may leave fields blank.)
Name: _________________________________ Title: __________________________________
Department: ___________________________ Email Address: __________________________
Office Phone: __________________________
Classification (Faculty, Non-Faculty, Student, other) _________________________________
Most recent date of alleged misconduct: ___________________________________________
When did the alleged discriminatory action start: ___________________________________
