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Discrimination/Sexual Harassment Complaint Form

For additional information, please review our policies regarding Equity and Discrimination for the following groups:


This form is designed to provide students, employees, faculty, vendors, or visitors with an on-line method for reporting alleged incident(s) of discrimination, harassment (including sexual misconduct), or retaliation.

You are not required to complete the entire form. You have the right to remain totally anonymous when filling out this form.

Harassment, Discrimination (Including Sexual Misconduct) and Retaliation Information

If you answered "Yes" above, please provide the name(s) and contact information of those to whom you reported.

By submitting this form, I certify that the information I have provided is true and accurate to the best of my knowledge. This report may be shared with all parties on a need to know basis for investigation. Additional information is found in the Midland College Policy (FFDA and FFDB).



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