Title VI Complaint Form - Willard Airport at the University of Illinois

To submit a Title VI Complaint to the University of Illinois Willard Airport, please complete the following form, and click the Submit button. You may attach any additional documentation you wish to submit to your complaint before sending. Alternatively, the form can be printed, completed manually, and returned to: University of Illinois Willard Airport, 11 Airport Rd, Savoy, IL 61874 or scanned and emailed to: willard-airport@illinois.edu. For questions or a full copy of the University of Illinois Willard Airport Title VI policy, please submit a written request to the above address, visit http://iflycu.com, or email your request to willard-airport@illinois.edu, or call (217) 244-8604.

Name(Required)

First Last

Phone

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Date of Incident (Must be within 180 days of incident)(Required)

Name of person(s) who allegedly discriminated against you, if known(Required)

Use UNKNOWN if you do not know the name of the person(s).

Discrimination Based On (Please check all that apply)(Required)

Race

Sex

Color

Age

National Origin/LEP

Religion

Provide a brief explanation of the incident and how you feel you were discriminated against, including how you feel others may have been treated differently than you. (You many attach additional written material when submitting this form)(Required)

Why do you believe the discrimination occurred?(Required)

What remedy are you requesting?(Required)

List any person(s) we may contact for additional information to support or clarify your claim (Name, Phone, Email Address)

Upload Documents

Please upload any additional documents.

Max. file size: 3 GB.

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