UMS Equal Opportunity Reporting Form

Definitions

Protected class: certain groups of individuals protected by anti-discrimination laws.

Disparate treatment: when a person is treated less favorably than others because of their membership in a protected class.

Disparate impact: when a policy or practice that is neutral on its face operates in a way that adversely impacts members of a protected class

Hostile environment: a pattern that is abusive and is based on protected class

Retaliation: Action taken against anyone who makes a complaint of discrimination or harassment or who is involved in a complaint process

What is the nature of your complaint?(Required)

Discrimination--Disparate Treatment (I have been treated less favorably than others because I am a member of a protected class.) Discrimination--Disparate Impact (I have been impacted by a policy or practice that is neutral on it's face but adversely impacts me because I am a member of a protected class.) Hostile Environment (I have been subjected to a pattern that is abusive and is based on protected class.) Retaliation (I have been retaliated because I have made a complaint of discrimination or harassment, or have been involved a complaint process.) Other (Please explain below.)

This field is required.

Pronouns are a way in which individuals opt to be identified. There are many pronouns currently in use. Some commonly used pronouns can be she, he, they, (and many more). We invite you to share your pronouns so that we can communicate with you appropriately: This field is required.

To assist us in understanding the details of your situation, please provide a description of what occurred and the reasons you feel you have been discriminated against. Please be as specific and detailed as possible. (As an example, you might provide dates of specific incidents and how these incidents are evidence of discrimination based on the protected class you identify with.)(Required) This field is required.

When did this occur? Any employee, student, or third party with a concern about discrimination or harassment by an employee or the University should contact the University Equal Opportunity Officer as soon as possible after the alleged incident. Complaints made later than one year after the alleged discrimination or harassment will not result in disciplinary action, absent extraordinary circumstances.(Required) This field is required.

Please provide the names (and roles at the University) of potential witnesses you feel it might be important to talk to about this situation (and include what knowledge or experience they may have that is relevant). The investigator will use their discretion to determine if these individuals will need to be contacted. This field is required.

UMS Equal Opportunity Reporting Form

Background Information

Involved Parties

Questions

Supporting Documentation

Submission