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2. ADA/Discrimination Complaint Form

   The City has established an ADA/ Discrimination complaint procedure and will take prompt and reasonable action to investigate and eliminate discrimination when found. Any person who believes that he or she has been subjected to an ADA violation or discrimination based upon race, color, national origin, sex, age, disability, religion, income or family status in any of the City’s programs, services or activities may file a complaint with the City Title VI/Nondiscrimination Coordinator by filling out the form below.  

   If possible, the complaint should be submitted in writing and contain the identity/contact information of the complainant for purposes of follow up; the basis for the allegations (i.e., race, color, national origin, sex, age, disability, religion, income or family status); and a description of the alleged discrimination with the date of occurrence. If the complaint cannot be submitted in writing, the complainant should contact the Title VI/Nondiscrimination Coordinator for assistance.

   The Title VI/Nondiscrimination Coordinator will respond to the complaint within thirty (30) days and will take reasonable steps to resolve the matter. 

4. Contact Information
6. First Name*
7. Last Name*
9. Address1*
11. Address2
13. City*
14. State*
15. Zip*
17. Phone Number*
18. Email Address*
20. Please indicate the nature of your problem by checking the appropriate box(es) below:
22. Type of ADA/Discrimination Complaint*

    1. ADA Complaint
    2. Discrimination Complaint

    1. ADA Website Accessibility

    1. Other
24. Brief Description (or other problem not listed)
26. Location of Problem
Leave This Blank:


28. 1. Receive an email copy of this form.
29. Email address

    This field is not part of the form submission.

30. Submit Submit and Print

* indicates a required field