This form may be used by reporting individuals or complainants, including employees, students and
visitors, who wish to file a complaint of sexual harassment, gender-based harassment and/or sexual
violence pursuant to CUNY’s Policy on Sexual Misconduct. CUNY’s policy prohibits retaliation
against any person who reports sexual misconduct, assists someone making such a report, participates in
any manner in an investigation or resolution of a sexual misconduct complaint, seeks interim or supportive
measures or accommodations pursuant to CUNY’s Policy on Sexual Misconduct, or opposes in a
reasonable manner an act or policy believed to constitute sexual misconduct.