Title IX Complaint Please fill out this form if you would like to formally file a Title IX Complaint Step 1 of 5 - Report filed by 20% EmailThis field is for validation purposes and should be left unchanged.Report filed by:*Victim/SurvivorThird PartyAnonymousCheck one:* Student Faculty Staff Applicant (Student/Employee) Other If you chose "Other" explain here:Name*A NumberGenderRaceLocal AddressCityStateZIP CodeHome PhoneCell PhoneWork PhoneCampus Email(If a student) ClassificationMajor(If an employee) Position/Title:College/Dept Type of Complaint (Check all that apply) Age Bullying (Cyber-bullying) Disability Gender Marital Status Medical condition National Origin Race Retaliation Religion Sexual Assault Sexual Harassment Sexual Misconduct Sexual Orientation Stalking Veteran Status Other Respondent NameGenderRaceThe respondent is:* Student Faculty Staff Applicant (Student/Employee) Other If you chose "Other" explain here:(If an employee) Position/TitleCollege/DepartmentYour relationship to the respondent (if any)Date/time of the alleged incidentLocation of the alleged incident Witness 1NameRelationshipPhoneWitness 2NameRelationshipPhoneWitness 3NameRelationshipPhone Has this incident been reported to any other department(s) at the University? Yes No College/DepartmentContact PersonDepartment LocationPhoneWas the incident reported to law enforcement? Yes No If yes, what agency?Describe in detail your complaint*Describe your feelings when the incident happened and the corrective action you are seeking*CAPTCHA