The completed AD-3027 form or letter must be submitted to USDA by: The letter must contain the complainant’s name, address, telephone number, and a written description of the alleged discriminatory action in sufficient detail to inform the Assistant Secretary for Civil Rights (ASCR) about the nature and date of an alleged civil rights violation. To file a program discrimination complaint, a Complainant should complete a Form AD-3027, USDA Program Discrimination Complaint Form which can be obtained online at:, from any USDA office, by calling (866) 632-9992, or by writing a letter addressed to USDA. Persons with disabilities who require alternative means of communication to obtain program information (e.g., Braille, large print, audiotape, American Sign Language), should contact the responsible state or local agency that administers the program or USDA’s TARGET Center at (202) 720-2600 (voice and TTY) or contact USDA through the Federal Relay Service at (800) 877-8339. Program information may be made available in languages other than English. Department of Agriculture (USDA) civil rights regulations and policies, this institution is prohibited from discriminating on the basis of race, color, national origin, sex (including gender identity and sexual orientation), disability, age, or reprisal or retaliation for prior civil rights activity. In accordance with federal civil rights law and U.S. Physician Form – Please have Physician complete form and fax to Janet Stone 67Īmharic | Arabic | Bengali | Burmese | Chinese | French | Hindi | Nepali | Somali | Spanish | Swahili | Telugu | Tigrinya | Vietnamese.This program supports the department’s mission to promote lifetime wellness to DeKalb County students and staff by serving meals that are high quality, nutritious, enjoyable, and economical. Each month, the DeKalb School Nutrition program will highlight at least one Georgia grown fresh fruit or vegetable in the cafeteria along with nutrition education regarding its origin. This is a national initiative that provides students fresh fruits and vegetables through the connection of instate farmers. Farm to School: The DeKalb County School Nutrition Program is working with Dexter’s Farm to bring Georgia grown fruits and vegetables to the students of DeKalb County Schools.Monthly Nutrition Tips – Bibb Lettuce is a good source of fiber, Vitamin A & K, potassium & Folate.(2) fax: (202) 690-7442 or (3) email: institution is an equal opportunity provider. Office of the Assistant Secretary for Civil Rights Submit your completed form or letter to USDA by: To request a copy of the complaint form, call (866) 632-9992. To file a program complaint of discrimination, complete the USDA Program Discrimination Complaint Form, (AD-3027) found online at:, and at any USDA office, or write a letter addressed to USDA and provide in the letter all of the information requested in the form. Additionally, program information may be made available in languages other than English. Individuals who are deaf, hard of hearing or have speech disabilities may contact USDA through the Federal Relay Service at (800) 877-8339. Braille, large print, audiotape, American Sign Language, etc.), should contact the Agency (State or local) where they applied for benefits. Persons with disabilities who require alternative means of communication for program information (e.g.
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