Report Employee Discrimination and Harassment

This form should be used by employees, students, school partners/contractors and others, to report acts of discrimination and harassment where employees are the alleged victim or alleged aggressor.

 NOTE: If you are reporting an incident of bullying where a student is the alleged victim, please use the Bullying and Harassment Form.

 

Employee Discrimination and Harassment Reporting and Investigation Form

  • General Information

  • Date Format: MM slash DD slash YYYY
  • Name of person completing this form (First, Last) * Required
  • Alleged Victim's Name (first, last) * Required
  • The alleged victim is:
  • Accused Person's Name (First, Last)
  • What is the relationship of the alleged victim to the accused person? Is the alleged victim:
  • Describe the Incident

  • Date Format: MM slash DD slash YYYY