Report of Discrimination or Bias

University of Mary Hardin-Baylor Report of Discrimination or Bias

NOTICE: If you are reporting discrimination on the basis of sex (including sexual harassment, sexual violence, dating/domestic violence or stalking), do not use this form. Please click here to use a more specific Report Form, or contact susan.owens@umhb.edu

What is your relationship to the incident?

Other

If you experienced the discrimination or bias, how did it affect you? (check all that apply)

What do you think was the basis of or motivation for the incident? (check all that apply)

Where did the incident(s) occur? (check all that apply)

When did the incident(s) occur? Please be as specific as you can. Do you know the date? Month? Season? Year? If you are reporting multiple incidents, provide a range.

Please describe the incident as completely as possible. Include what led up to the incident and what happened. What was said? What happened after the incident? Who was responsible for the incident, including names or job titles if you know them. Were others present - students, friends, faculty, staff, etc.? (You can include their names below if you want to.)

Did incidents like this occur more than once?

If you want to provide names and contact information for anyone who witnessed the incident(s) or may have information about it, please include that here. This information may include first and last name, and status (student, employee, etc.,) and contact information if known.

If you wish to submit supporting documentation (documents, photos, texts, emails, social media screen shots, etc.)

Browse Files

I am a:

What would you like to see happen as a result of your report?

Are you submitting this report for:

Name

First NameLast Name

Phone Number

Area CodePhone Number

Email

example@example.com

Thank you for speaking up about your concerns!