CC/SEAS Bias Report

Your Information

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Your full name:

Your Columbia Affiliation:

Your UNI:

Your Phone Number:

Email address must be of a valid format.

Date of incident(Required):

This field is required.

Time of incident:

Location of incident(Required):

This field is required.

Specific location:

Involved Parties

Please enter the individual(s) involved below excluding yourself. To look up a student, please click on the binoculars above the Name field.

For student organization(s) and/or group(s), please enter the organization name with no spaces in the UNI field (Example: “Alpha Beta” would be entered as “alphabeta”).

For non-students, please provide any relevant identifying details.

Name or Organization

Select Gender

Columbia UNI (if known)

Email Address (if known)

Phone number (if known)

Relationship to Columbia

Narrative/Details of Concern

Please provide a narrative of the incident. Be sure to provide as much information as possible about the incident.(Required) This field is required.

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.

Your Information

Involved Parties

Narrative/Details of Concern

Supporting Documentation

Submission