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indicate you will have an Advisor, you are authorizing that individual to accompany you to any meeting(s) and/or interview(s) regarding this complaint. The role of the Advisor is limited to observing and consulting with you. 9. If you have selected an Advisor, please provide the name and telephone number of your Advisor. Last Name First Name MI Telephone Mobile Phone AUTHORIZATION I certify that the information given in this complaint is true and correct to the best of my knowledge or belie.

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How to fill out the CA CSU EO 1096 online

This guide provides a comprehensive overview of how to fill out the CA CSU EO 1096 complaint form for discrimination, harassment, and retaliation. By following these instructions, users can effectively complete the form to ensure their concerns are properly addressed.

Follow the steps to complete the CA CSU EO 1096 form online.

  1. Click ‘Get Form’ button to access the CA CSU EO 1096 form and open it for editing.
  2. Begin by entering the name of the CSU campus you are addressing in the designated field. This identifies where your complaint is directed.
  3. Fill in the department associated with your complaint to provide context.
  4. Complete the personal information section, including your last name, first name, middle initial, mailing address, city, state, email, zip code, home phone, work phone, and mobile phone.
  5. Indicate the best time to be contacted by specifying AM or PM.
  6. Clarify your relationship with the CSU campus by selecting from the options provided, such as current employee, applicant for employment, former employee, or third party.
  7. Specify the type(s) of complaint you are filing, including discrimination and/or harassment. You can also indicate if informal resolution was sought.
  8. If your complaint involves discrimination or harassment, tick all applicable protected statuses that apply to your situation.
  9. Provide details about the accused individual(s), including their names and your relationship with them.
  10. Describe the incident(s) leading to your complaint, including specifics like dates, times, and locations.
  11. Detail any sexual harassment or violence you are reporting, if applicable, with relevant information.
  12. Outline the specific harm you suffered as a result of the incident(s).
  13. Explain actions taken to resolve the issue, along with the outcomes of those actions.
  14. List anyone who may have witnessed the incidents, providing their contact information for follow-up.
  15. If available, indicate any supporting documents for your complaint and provide copies.
  16. Describe the expected outcomes from your complaint, being as clear as possible.
  17. If you choose to have an advisor, provide their name and contact information.
  18. Finally, certify the information is true by printing your name, entering the date, and providing your signature.
  19. Once completed, review the form for accuracy and completeness before saving changes, downloading, printing, or sharing it as needed.

Ensure your voice is heard by completing the CA CSU EO 1096 complaint form online today.

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CSU Systemwide policy prohibits discrimination, harassment and retaliation, sexual misconduct, sexual exploitation, dating and domestic violence, and stalking against students, employees, and third parties.

CSU Executive Order 1096 is the Systemwide Policy Prohibiting Discrimination, Harassment, Retaliation, Sexual Misconduct, Dating and Domestic Violence, and Stalking against Employees and Third Parties and Systemwide Procedure for Addressing Such Complaints by Employees and Third Parties and was revised on August 24, ...

Interim CSU Policy Prohibiting Discrimination, Harassment, Sexual Misconduct, Sexual Exploitation, Dating Violence, Domestic Violence, Stalking & Retaliation.

The CSU protects people from discrimination based on age, disability, gender, genetic information, gender identity or expression, nationality, marital status, race or ethnicity, religion, sexual orientation, and veteran or military status.

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