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REPORT OF DISCRIMINATION/HARASSMENT/ABUSE Name of Complainant (First, MI, Last, Suffix) Check One: Student Employee Home Address and Phone #: If Student: Is Employee: School Attending: Position: Grade:
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How to fill out a report of discrimination, harassment, or abuse?

01
Start by gathering information: Collect all relevant details about the incident, including dates, times, locations, names of individuals involved, and any supporting evidence such as emails, text messages, or photographs.
02
Clearly describe the incident: Provide a detailed account of what happened, focusing on the specific actions or behaviors that were discriminatory, harassing, or abusive. Be objective and avoid speculation or personal opinions.
03
Include the impact: Discuss the impact of the incident on you or others involved. Explain how the discrimination, harassment, or abuse affected your emotional well-being, work performance, or any other areas of your life.
04
State the desired outcome: Specify what you hope to achieve through filing the report. This could be seeking an investigation, disciplinary action, or implementing policies to prevent future incidents.
05
Maintain confidentiality: It is crucial to ensure the confidentiality of your report. Only share the information with individuals who need to be involved in the investigation or resolution process.
06
Submit the report: Submit the completed report to the appropriate authority or organization, following their designated procedures. This may involve submitting the report online, via email, or in person.

Who needs a report of discrimination, harassment, or abuse?

01
Employees: If you have experienced or witnessed discrimination, harassment, or abuse in the workplace, it is essential to file a report. This will help ensure that the issue is addressed and appropriate action is taken to create a safe and inclusive work environment.
02
Students: For individuals attending educational institutions, filing a report is crucial in holding accountable those responsible for discrimination, harassment, or abuse. This can help protect students' rights and contribute to a healthy learning environment.
03
Members of organizations or communities: Those who are part of various organizations or communities, whether social, cultural, or recreational, should report incidents of discrimination, harassment, or abuse to maintain the integrity, inclusivity, and safety of their chosen communities.
By following these steps and filing a report, individuals can contribute to a safer and more inclusive environment while seeking justice and resolution for incidents of discrimination, harassment, or abuse.
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