Sub Navigation Equity Ethics Accessibility EEOC COVID-19 Guidance Intake Form Search This form will provide Compliance, Diversity and Ethics (CDE) with basic information regarding alleged incidents of protected class discrimination or ethics violations at George Mason University. An asterisk (*) indicates a required field. Please fill out all requested information and click 'submit'. Information provided will be treated in the strictest confidence possible. To provide information regarding alleged incidents of sexual or interpersonal misconduct, please click here to fill out our Title IX Report Form. If you need a reasonable accommodation for a disability in order to participate in this process, please notify CDE and someone will assist you. Name Preferred Pronouns - select -He/Him/HisShe/Her/HersThey/Their/TheirsZe/Zir/Zirs GMU Affiliation * - select -Undergraduate StudentGraduate/Professional StudentApplicant (Student)FacultyStaffContractorJob ApplicantVisitor to CampusOther Mailing Address * Contact Phone * Email Address * TTY Basis of Complaint and/or Alleged Discrimination * For discrimination under Title VII of the Civil Rights Act of 1964 (definitions), please select the category or categories that best describe your allegation(s). Hold the CTRL (or CMD) key to select multiple. Type of Discrimination Age (40+)ColorDisability - ADADisability - OtherGender ExpressionGender IdentityGenetic Information (GINA)Marital StatusNational OriginPregnancy StatusRaceReligionSex/Gender (Employee)Sexual OrientationVeteran Status Ethics Violations - select -Conflict - ResearchConflict - ContractEthics - OtherNepotism Complaint Respondent Name - Please provide the name of the person you are reporting * Respondent GMU Affiliation * - select -Undergraduate StudentGraduate/Professional StudentFacultyStaffContractorOther Brief Account of Incident(s) *
