Nondiscrimination Report Form:

Background Information

Minnesota State Mankato takes incidents of discrimination, discriminatory harassment, sexual harassment, and/or retaliation seriously and will investigate those allegations to the best of its ability. As a result, the University will follow up on any specific, identifying information provided in this report.

To submit an anonymous report of discrimination, discriminatory harassment, or sexual harassment, please fill out the form below to the best of your ability and comfort.

Your full name:

Your position/title:

Your phone number:

Your email address:

Email address must be of a valid format.

Your physical address:

Date of Most Recent Incident(Required):

This field is required.

Time of incident:

Location of incident(Required):

This field is required.

Specific location:

List of All Parties Involved

Please provide identifying information about each individual involved in the incident.

Name or Organization

Role of Person in Incident

STAR ID

DOB (YYYY-MM-DD)

Phone number

Email address

Hall/Address

Questions

Supporting Documentation

Please provide any additional information that may be helpful. 5GB maximum total size.
Attachments require time to upload, so please be patient after submitting this form.

Email me a copy of this report

Background Information

List of All Parties Involved

Questions

Supporting Documentation

Submission