Complaint of Discrimination, Harassment and/or Retaliation Form

 

In the event of an emergency, call 911

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What To Do If You Believe You Have Experienced Discrimination

 

If you think that you have been subjected to discrimination under a WIA Title I–financially assisted program or activity, you may file a complaint within 180 days from the date of the alleged violation with:

Equal Opportunity Officer & Title IX Officer

SCOTT DILLIN

30 Cumberland Avenue
Asheville, NC, 28801
United States

(828) 259-5305 / (828) 398-6777 (TDD/ TTY) (TDD/ TTY provided by Ringfree Communications.)

scott.dillin@abccm.org

 

 

If you file your complaint with ABCCM, The Compliance Officer or Executive Director will respond within 3 business days and we will open an investigation.  We will complete the investigation within 60 days and issue a written finding(s).

 

·        You must wait either until the recipient issues a written Notice of Final Action, or until 90 days have passed (whichever is sooner), before filing with the Civil Rights Center.  Director, Civil Rights Center (CRC), U.S. Department of Labor, 200 Constitution Avenue NW, Room N–4123, Washington, DC 20210.


Please fill out the form below as completely as possible

Name *
Name
Phone Number *
Phone Number
Address
Address
Date of Incident *
Date of Incident
The discrimination, harassment and/or retaliation allegation is based on: *
Include a description, date(s) of the incident(s), and name(s) of witness(es). Please send an email to Scott.dillin@abccm.org if you need additional space or wish to submit supporting documents.
Have you brought your complaint to the attention of any other Program Director? *