Completion of this form is not required to formally initiate a complaint; however, completing this form will assist in the investigatory process. When completed, please return this form to the Director of Human Resources, Room 107, Walter Washington Administration/Classroom Building (WWACB). You will be contacted as soon as possible for a confidential interview. The information you provide below is considered sensitive and will be shared only with those who are considered essential to the investigation and disposition of this complaint.

Personal Information

Alcorn State University is an equal opportunity employer. It is the University's policy that all employees have a right to work in an environment free of discrimination and harassment based on sex, age, race, color, national origin, religion, disability, or any other basis protected by federal, state, or local law.