My name is:
I am a student/employee (Choose One) at the School District of Rhinelander.
Name of person who sexually harassed you.
The date that the harassment occurred.
The time that the harassment occurred.
The location the harassment occurred.
Insert Allegations
I am requesting that the district investigate these allegations.
By selecting the “I agree” button, I am signing this document electronically. I agree that my electronic signature is the legal equivalent of my manual/handwritten signature on this document.
Digital Signature: (Type your name in the box.)