Discrimination/Sexual Misconduct Report - 卡塔尔世界杯时间表

Background Information

This form is designed to provide Adelphi University students, staff, faculty, vendors, or visitors with an easy method to report specific information related to an alleged incident(s) of discrimination, harassment (including sexual misconduct), or retaliation.

你无须填妥整份表格，便可提交指控。大学将使用所提供的信息进行调查，包括联系投诉人、答辩人和/或任何可能的证人。但是，如果报告没有包含具体的信息，大学的调查和回应可能是有限的。

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Your full name:

Your phone number:

Your email address:

Your physical address:

Nature of this report(Required):

This field is required.

Relationship between involved(Required):

This field is required.

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Identify the relationship between the parties (Complainant-Accused)

Date of incident(Required):

This field is required.

Time of incident:

Location of incident(Required):

This field is required.

Specific location:

Involved Parties

Please list all of the involved parties in this incident, including yourself.

Name or Organization

Gender identity

Select Role

ID Number

DOB (YYYY-MM-DD)

Phone number

Email address

Hall/Address

Questions

Supporting Documentation

Please use this section to upload any supporting information. (any file type is accepted) 5GB maximum total size.
Attachments require time to upload, so please be patient after submitting this form.

Email me a copy of this report

Background Information

Involved Parties

Questions

Supporting Documentation

Submission