The City University of New York
Sexual Misconduct Allegation Form

This form may be used by reporting individuals or complainants, including employees, students and visitors, who wish to file a complaint of sexual harassment, gender-based harassment and/or sexual violence pursuant to CUNY’s Policy on Sexual Misconduct. CUNY’s policy prohibits retaliation against any person who reports sexual misconduct, assists someone making such a report, participates in any manner in an investigation or resolution of a sexual misconduct complaint, seeks interim or supportive measures or accommodations pursuant to CUNY’s Policy on Sexual Misconduct, or opposes in a reasonable manner an act or policy believed to constitute sexual misconduct.

PART A
Contact/Cell Number Format (###)###-####
PART B

Summary of Sexual Misconduct Allegation

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I acknowledge and agree that by clicking “Submit” will act as my electronic signature to this Sexual Misconduct Allegation Form, as well as my affirmation that the above allegation(s) is true to the  best of my knowledge, information and belief.