image 1Biology Department
Graduate Programs

This form is designed to provide Adelphi University students, staff, faculty, vendors or visitors with an on-line method to report specific information related to an alleged incident(s) of harassment.

You are not required to complete the entire form in order for the allegation to be submitted, however, if the report does not contain some specific information, an investigation cannot be started. For example, if the complaint is general, in that, Professor Smith uses obscene language in the Art 101 Sculpture course, an investigation can be conducted. Conversely, if the report states that Professor Smith asked me out (but you fail to give a name), an investigation cannot be conducted.

Are you a: student employee vendor visitor applicant

If you wish to identify yourself, please enter your name and phone number for contact purposes:

Your Name: Telephone Number:

Date(s) and time(s) of incident(s):

Location(s) of incidents:

Witnesses to incidents:

Statement of actions or practices alleged to constitute harassment (please provide as much detail as possible):

Thank you for your information. Adelphi University is committed to providing an environment which is free from harassment and is committed to investigating any and all allegations of harassment.

This form will be forwarded to the Office of Human Resources and investigated according to the processes delineated in the Anti-Harassment Policy. We recommend familiarizing yourself with this policy and process, which is available at http://admin.adelphi.edu/hr/policies/harassment.php

In order to protect your anonymity, you will not receive an acknowledgement of this email and your email address will not be forwarded to the Office of Human Resources.
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Contact Us
For more information, please contact:

Office of Human Resources
p - 516.877.3220
f - 516.877.4970
e - humanres@adelphi.edu

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