Columbia University Discrimination and Sexual Harassment Inquiry Form

The following form will allow you to send notice of a discrimination or sexual harassment inquiry electronically to the Office of Equal Opportunity and Affirmative Action. After you have sent the Inquiry Form, please call the office at (212) 854-5511 to set up an appointment with a member of the staff. To initiate a formal complaint, you will need to visit the Office of Equal Opportunity to speak with a member of the staff and submit a signed statement.

Please describe in detail the incident(s) giving rise to this inquiry.  Include as many of the following items as possible:

• the name of the accused;
• the name(s) of witnesses to the incident(s) or individuals who have knowledge of the incident(s);
• the date(s) of the incident(s);
• the type of inquiry that you are making [sexual harassment, race, color, national and ethnic origin, age, religion, sex, disability, sexual orientation, marital status, citizenship, or status as a Vietnam-era or disabled veteran]
• the proposed remedy that you are seeking;
• your status at the University [student, faculty, administrator, support staff, researcher, librarian]; and
• other contributing factors.

School/Department/Division: 

Address: 

Phone:   Email: 

Job Title (if applicable): 

Date: 

Description of Inquiry: