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Discrimination and Sexual Harassment Complaint Form


Monroe Community College is committed to providing a safe, inclusive, and respectful learning, living, and working environment for its students, faculty, and staff members free from unlawful discrimination based on protected categories.

This form can be used by students, employees, and third parties to file a complaint of discrimination based on race, color, national origin, religion, creed, age, disability, sex, gender identity, sexual orientation, familial status, pregnancy, predisposing genetic characteristics, military status, domestic violence victim status, or criminal conviction.

If your immediate safety is at risk, if you are witnessing violence, or if you perceive imminent harm to yourself or others, please immediately dial 585-292-2911.

Background Information

What happens after I fill out this form? After submitting this form, College administration will evaluate the report and take appropriate steps to respond.

Can I submit this form anonymously? Yes, this form may be submitted anonymously. The College takes all reports of discrimination and sexual harassment seriously, but its ability to resolve an issue will be limited if it is reported anonymously.

Is the information supplied in this form confidential? While the College will endeavor to maintain the privacy of reporters, consistent with College policy and the law, details of a complaint may need to be shared (including the identity of the reporter) in certain circumstances for the College to take the appropriate action.

If you have questions about completing this form or your reporting options, please contact the Student Rights and Responsibilities Office at studentrights@monroecc.edu or 585-292-2023 or the College's Chief Diversity Officer at diversity@monroecc.edu or 585-292-2122.

Reporter and Background Information

 
Email address must be of a valid format.
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Please indicate the type of incident.
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Urgency of this report
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Involved Parties

Starting with yourself, list all parties associated with this incident report. If you are reporting anonymously, please write "anonymous" in the name field. If an organization is involved, please list the organization.

Involved party 1

Questions

Select the perceived motive for the incident. Check all that apply.(Required)
You must make at least one selection.
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Supporting Documentation

Photos, video, email and other supporting documents may be attached below. 5GB maximum total size.
Attachments require time to upload, so please be patient after submitting this form.

Submission