Women's Sexual Harassment Complaint Form 
In pursuance of UGC (Prevention , Prohibition and Redressal of Sexual
Harassment of Women Employees and students in Higher Educational
institutions).Regulations , 2015 read with Sexual Harassment of Women at
Workplace (Prevention , Prohibition and Redressal) Act , 2013 and in partial
modification of Office order No.449 dated 05.08.2016 , Women Anti Harassment Committee (Vishakha Cell) is constituted as under to deal the complaints relating to
Sexual Harassment at work place
Email *
Name of the complainant (the one registering the complaint)  *
Mobile No. *
Category to which complainant belongs  *
Name of offender/offenders (against whom complaint is to be registered) *
Category to which offender belongs  *
Date when the incident took place.  *
MM
/
DD
/
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Time when the incident took place.  *
Time
:
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