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TITLE IX
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Equal Opportunity Programs
1600 Hampton Street
Suite 805
University of South Carolina
Columbia, South Carolina 29208

Phone: 803-777-3854
Fax: 803-777-2296
TDD: 803-777-5608

Discrimination/Harassment Complaint Form

University of South Carolina • Office of Equal Opportunity Programs
1600 Hampton Street, Suite 805, Columbia, SC 29208
(Ph) (803) 777-3854 (Fax) (803) 777-2296
* - required fields
Name: *
Address: *
City, State, Zip: *
Home Phone: *
Business Phone:
Department: *
 
Nature of discrimination/harassment (check all that apply): *

Age
Color
Disability
Gender
National origin
Genetics
Race
Religion
Sexual harassment
Sexual orientation
Veteran's status

 
Date of Alleged discrimination: *
Department/individual whom you believe has discriminated against you: *
May we contact department/individual? Yes No *
 
Describe alleged incident: *
Remedy requested:

Please enter the security words below:

 
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