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Title IX Complaint Form

  1. Thurston Regional Planning Council Logo
  2. Title VI Complaint Form
    Title VI of the Civil Rights Act of 1964 requires TRPC programs to ensure protection from discrimination on the basis of race, color and national origin. This form may be used by anyone who believes he or she has experienced discrimination.
  3. Questions
    If you have questions or need assistance, contact the TRPC Title VI Coordinator at 360-956-7575.
  4. Section I
  5. Section II
  6. Are you filing this complaint on your own behalf?
    If you answered Yes to this question, proceed to Section III.
  7. Please confirm you have obtained permission from the aggrieved party.
  8. Section III
  9. I believe the discrimination I experienced was based on:
    Select all that apply.
  10. Section IV
  11. Have you previously filed a Title VI complaint with this agency?
  12. Signature
    By checking this box, I authorize my signature.
  13. Leave This Blank:

  14. This field is not part of the form submission.