NCDOT - Title VI Demographics
NCDOT - Title VI Demographics
Completing this form is completely voluntary and anonymous
You are not required to provide the information requested in order to participate in any meeting.
In accordance with Title VI of the Civil Rights Act of 1964 and related authorities, the N.C. Department of Transportation assures that no person(s) shall be excluded from participation in, denied the benefits of, or subjected to discrimination under any of the Department’s programs, policies, or activities, based on their race, color, national origin, disability, age, income, or gender.
Completing this form helps meet our data collection and public involvement obligations under Title VI and NEPA, and will improve how we serve the public.
Please complete the form and return it in one of the following manners:
- Complete the form online by answering the questions below
- Download the fillable form, complete it and email it to NCDOT-TitleVI@publicinput.com
- Download the fillable form, complete it and Mail it to Environmental Analysis Unit, 1598 Mail Service Center, Raleigh, NC 27699-1598.
All forms will remain on file at the NCDOT as part of the public record.
If you prefer to email or mail the form:
Download a copy of the form NCDOT Title VI Form
- Download the fillable form, complete it and email it to NCDOT-TitleVI@publicinput.com
- Download the fillable form, complete it and Mail it to Environmental Analysis Unit, 1598 Mail Service Center, Raleigh, NC 27699-1598.
Notice of Nondiscrimination and Accessibility Rights
In accordance with Title VI of the Civil Rights Act of 1964 and other nondiscrimination authorities, the N.C. Department of Transportation will not exclude from participation in, deny the benefits of, or subject to discrimination any person, based on race, color, national origin, Limited English Proficiency, income-level, sex, age, or disability (or religion, where applicable), under any NCDOT-funded programs or activities.
If you feel you have been discriminated against by NCDOT or its business partners, you may file a complaint. For information on filing a complaint or NCDOT’s nondiscrimination obligations, please contact:
NCDOT Office of Civil Rights
Title VI Nondiscrimination Program
1511 Mail Service Center
Raleigh, NC 27699
919-508-1808 or 800-522-0453
You may also visit: https://www.ncdot.gov/programs/titleVI/
Anyone with a hearing or speech impairment may contact Relay NC by dialing 711 or 1-877-735-8200.
ATTENTION:
If you speak a language other than English, qualified interpreters or information written in other languages are available, free of charge, by calling 1-800-481-6494.
For more information regarding Title VI or this request, please contact the NCDOT Title VI Nondiscrimination Program at
(919) 508-1808 or toll free at 1-800-522-0453, or by email at titleVI@ncdot.gov. Thank you for your participation!