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Nondiscrimination & Accessibility Process Complaint Form

  1. Filing a complaint

    The following information is needed to assist in processing your complaint/grievance.  Please complete the form and either submit electronically or print, complete and send to City of Grand Junction ATTN: Wanda Winkelmann, 250 N. 5th St. Grand Junction, CO 81501

    This complaint/grievance procedure is solely for facilities, programs, and services owned and/or operated by the City of Grand Junction, CO. If your grievance is related to a non-City owned operation (Title III businesses), please contact the U.S. Department of Justice Information Line at 1-800-514-0301 for assistance.

  2. Section 1. Contact Information
  3. Section 2. Complainant Information
  4. Are you filing this complaint on your own behalf?
  5. If yes, skip to Section 3. If no, please provide the following contact information for the person discriminated against:
  6. Section 3. Incident Description
  7. Have you discussed your complaint with a City employee?
  8. 29. Have you filed your complaint with a federal, state, or local agency; or with a federal or state court?
  9. Have you filed a complaint with any other federal, state or local agency or with any federal or state court? Check all that apply.
  10. Allowed types: .gif, .jpg, .jpeg, .png, .doc, .docx, .xls, .xlsx, .rtf, .pdf, .txt

  11. By inputting my name below, I affirm that the above is true to the best of my knowledge, information, and belief.
  12. Leave This Blank:

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