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  • The Equity and Access Office Complaint Form

Related Policies and Information on the Complaint Process

The Equity and Access Office Complaint Form

"*" indicates required fields

I. Personal Information

Name
Anonymous
Please note that requesting anonymity may limit the University's ability to address the complaint. If you disclose your name and contact information on this form, you may still discuss with EAO whether it is possible to remain anonymous when exploring options to address your complaint. The request will be considered in light of the due process rights of all involved, the severity of the harassment, the potential risk to other members of the University community, and any related legal obligations. If the request cannot be honored, you will be advised accordingly. If you wish to discuss the situation anonymously with an EAO staff member, please call 928-523-3312.
Home Address
Work Address

II. Relationship to NAU

III. Employee/Student Information

IV. Person(s) you Believe are discriminating against you or harassing you

Name

V. Person(s) you believe may have knowledge of discriminatory or harassing treatment you received

Name

Type of Complaint: On what basis do you believe you were discriminated against or harassed?

Check all that apply: * Required

VII. Briefly Describe How You Believe You were Discriminated Against or Harassed

MM slash DD slash YYYY

VIII. Actions you have taken to date:

Name
MM slash DD slash YYYY

IX. What would you consider appropriate resolution to your complaint?

Though the university cannot guarantee a particular outcome, we invite you to share your desired resolution for the situation.
By checking the box below, I understand that this complaint will be forwarded to the Equity and Access Office in accordance with the Nondiscrimination and Anti-Harassment Policy.
I understand that the Equity and Access Office cannot promise confidentiality. I will discuss any particular concerns I have regarding confidentiality with the assigned investigator.
Affirmation * Required
This field is for validation purposes and should be left unchanged.

Equity and Access Office
Location
Room 113 Building 10
Old Main
PO Box: 4083
Flagstaff, AZ 86011
Contact Form
Email
equityandaccess@nau.edu
Phone
928-523-3312