Online notification form: Report discrimination

Do you

• Believe you have been discriminated against at the University of Göttingen based on (ascribed) characteristics, would you like to report your experience and/or do you wish for an individual counseling appointment?
• Have witnessed discrimination at the University of Göttingen, which you would like to report?
• Have had a discriminatory or disadvantageous experience at the university, but are uncertain whether this is the adequate counseling center?

You are welcome to forward your report to the Anti-Discrimination Counseling for students at the University of Göttingen. We will give you an estimation regarding support possibilities, so you can decide which further actions are suitable for you. Depending on the type of your experienced discrimination, we offer you direct support or make sure to refer you to an adequate counseling center (on- or off-campus).

If you want to report solely the observation of discriminatory behavior/incidents, you can send your notification in anonymized form. By sending us your report about the situation you witnessed you help us to get a better perspective of the occurrences at the University of Göttingen.

Reports of experienced or witnessed discriminations are being anonymized. No personal data will be passed on to third parties. If any further details should be treated confidentially, please specify in the box provided under the heading “further comments”.

You can send the notification form with or without your name on it to the Anti-Discrimination Counseling for students. Of course, all your statements are voluntary. Please note that in case of queries or regarding the possibility of individual support, we can only get in touch with you if you leave your e-mail address or phone number.







Please indicate whether you were discriminated against, whether you witnessed discrimination.

- I have been discriminated against at the University of Göttingen.

I have witnessed discrimination at the University of Göttingen.

I. What have you experienced/witnessed?

Please describe your experience/observation.

II. Where and when have you experienced/witnessed this?

If possible, please specify the place, date and time.

III. Would you like us to contact you?

Please provide the following information

I wish for an individual counseling appointment. Please contact me.

I'm available for further questions.

I don't want to be contacted.

Name

E-mail Address:

Phone Number:

IV. Further Comments

Space for additions

Privacy

I agree that, if I report an observation, the information I give in this form (in particular answers I and II) are being collected and processed anonymously.

I agree that for further processing of my complaint, personal data are being saved for the purpose of personal counseling and support by the Anti-Discrimination Counseling for students.


Please note the information sheet Data Protection Policy “Hinweisblatt zu Art. 13 der EU-Datenschutzgrundverordnung“ (see above). You may revoke your permission for us to do so at any time by sending an e-mail to antidiskriminierungsberatung@uni-goettingen.de. You can find detailed information regarding privacy and the use of your personal data in the data protection policy of the Georg-August-Universität Göttingen.

By submitting this form, you confirm that you have read and accept our Privacy Policy.