Your Rights Under Title VI: Race, color or national origin

Arrowhead Transit pledges that you will have access to all its programs, services and benefits without regard to race, color or national origin.

If you believe that you have been discriminated against, you may file a complaint with the Arrowhead Transit Office of Administration. Complaints may be filed within 180 days following the alleged discriminatory action by mail (Arrowhead Transit, 702 3rd Avenue South, Virginia, MN 55792) or by phone (218-735-6814). LEARN MORE about our Title VI Complaint Procedure HERE

Tell us how, when, where and why you believe you were discriminated against. Give your name, address and phone number. You must sign and date your letter. Or you can access the Title VI complaint procedure and form below. You can also access a PDF Title VI form found HERE

Upon request, this publication will be made available in alternative formats to people with disabilities and language requirements. LEARN MORE about our Language Assistance Plan HERE

Call the Transit Team at 1-800-862-0175 for more information or with questions. NOTICE TO THE PUBLIC

Section I:

Name (required)

Address (required)

Phone (Home) (required)

Phone (Work) (required)

Email (required)

Accessible Format Requirements? (required)

Section II:

Are you filing this complaint on your own behalf?

If you answered yes to the previous question, go to Section III.

If not, please supply the name and relationship of the person for whom you are complaining.

Please explain why you have filed for a third party:

Please confirm that You have obtained the permission of the
aggrieved party if you are filing on behalf of a third party.

Section III

I believe the discrimination I experienced was based on (check all that apply):

RaceColorNationl Origin

Date of Alleged Discrimination:

Explain as clearly as possible what happened and why you believe you were discriminated against. Describe all persons who were involved. Include the name and contact information of the person(s) who discriminated against you (if known) as well as names and contact information of any witnesses.

Section IV

Have you previously filed a Title VI complaint with this agency?

Section V

Have you filed this complaint with any other Federal, State, or local agency, or with any Federal or State court?

Please provide information about a contact person at the agency/court where the complaint was filed

Name

Title

Agency

Address

Phone

Section VI

Name of agency complaint is against

Contact person

Title

Phone

Title VI

Your Rights Under Title VI: Race, color or national origin

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