Hostos Online Complaint Form

Please use this form to file a complaint of sexual misconduct or any other type of discrimination based upon race, gender and/or gender identity or expression, marital status, color, creed, religion, ancestry, age, national origin, ethnicity, disability, veteran or military status, pregnancy, sex, sexual orientation, marital status, citizenship status, status as a victim of domestic violence, stalking or sex offenses, retaliation, or any other legally prohibited basis in accordance with Federal, State and City Laws.

Completion of this form will initiate a complaint with the Office of Compliance and Diversity (“OCD”) at Hostos which is an internal unit charged with investigating allegations of discrimination and sexual misconduct at the College in accordance with the CUNY Policy on Equal Opportunity and Non-Discrimination Policy and the CUNY Sexual Misconduct Policy. Information is shared with additional parties on a need to know basis depending on the facts.

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Today's date:

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Today


Was the act committed online?
How were you affected?
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Have you previously made a complaint with OCD and/or reported your concerns to a supervisor?
Have you reported your complaint with any other office on campus? If yes, where?
Have you filed this charge with a federal, state or local government agency/court? If yes, with which agency/court?
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What action, if any, are you requesting?



Street address, P.O. box, c/o
Apartment, suite, unit, floor








Would you like to remain anonymous?


I understand that a request to remain anonymous will limit the College’s ability to thoroughly address my complaint of alleged discrimination or harassment. Additionally, I understand that even though I may have requested confidentiality, my request may not be honored if my safety or the safety of others could be compromised.

I understand that if I have any questions regarding any of this information, including the filing of this form and confidentiality, it is my responsibility to meet and discuss those questions with the appropriate staff member in the Office of Compliance and Diversity.

If you are choosing to remain anonymous, it is not required that you check the box below and provide your name.



 
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