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Sexual Harassment Form

Sexual Harassment Formal Complaint Form

Your form will be submitted to the LCCC Title IX Coordinator.

To complete the form in person, please visit the LCCC Campus Security Office in the LCCC Bass Library, room LC 106.

Date of Incident
Time of Incident
Location
Description of the Incident(s)
Your Involvement
Your Affiliation
Name of Person(s) Accused of Wrongdoing
Name of Witnesses
Your Name
Phone
Email

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