This form is used to report information about an allegation of discrimination, harassment, sexual or gender-harassment, domestic or dating violence, stalking or retaliation to the University's Title IX Coordinator/EO Officer. Reporters may decide what information they choose to report on this form.

It is unlawful to retaliate against a student, employee or any other person affiliated with the University for filing a complaint or for cooperating in an investigation of a complaint.

All parties to a complaint may have a personal advisor (for union employees this may be a union representative) assist them throughout the process, in accordance with the EO Plan and the Sexual Violence Policy, and applicable collective bargaining agreements.

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To the best of my knowledge and belief, the above information is complete, true and accurate and not a “false charge” as defined under the EO Plan and the Sexual Violence Policy, and I hereby submit this complaint under the University’s Complaint Investigation and Resolution Procedure