Pelham Union Free School District Sexual Harassment Complaint Form
This file is a complaint form for reporting incidents of sexual harassment in the Pelham Union Free School District workplace. It includes sections to describe the incident, identify the alleged harasser, and provide witness information. Instructions for submission and investigation are also included.
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How do I fill this out?
To fill out this form, start by providing your personal information in the complainant section. Next, describe the incident, including dates and witness information. Finally, sign and date the form before submission.
How to fill out the Pelham Union Free School District Sexual Harassment Complaint Form?
1
Provide your name, work address, and job title.
2
Select your preferred communication method.
3
Describe the incident and how it affected your work.
4
List any witnesses and their contact information.
5
Sign, date, and submit the form.
Who needs the Pelham Union Free School District Sexual Harassment Complaint Form?
1
Employees who have experienced sexual harassment and need to report it.
2
Supervisors who need to document a report of sexual harassment.
3
HR personnel responsible for handling sexual harassment complaints.
4
Legal counsel assisting an employee with a sexual harassment complaint.
5
Witnesses who need to provide information related to a sexual harassment incident.
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What are the instructions for submitting this form?
Submit this form to the Civil Rights Compliance Officer (CRCO) at the Pelham Union Free School District. Email: crco@pelhamufsd.org. Fax Number: 914-738-8121. Physical Address: 18 Franklin Place, Pelham, NY 10803. Online submission forms are available on the District's website. Please ensure all fields are completed and any additional documents are attached before submission.
What are the important dates for this form in 2024 and 2025?
There are no specific dates for submitting this form in 2024 and 2025. Submit the form as soon as possible after an incident occurs.
What is the purpose of this form?
The purpose of this form is to provide a standardized way for employees to report incidents of sexual harassment in the Pelham Union Free School District workplace. It ensures that all necessary information is collected to facilitate a thorough investigation. By providing this form, the District aims to address and rectify instances of sexual harassment promptly and effectively.
Tell me about this form and its components and fields line-by-line.
- 1. Name: The full name of the complainant.
- 2. Work Address: The work address of the complainant.
- 3. Job Title: The job title of the complainant.
- 4. Preferred Communication Method: The preferred method of communication for the complainant (Email, Phone, In person).
- 5. Immediate Supervisor's Name: The name of the complainant's immediate supervisor.
- 6. Title: The title of the immediate supervisor.
- 7. Work Phone: The work phone number of the immediate supervisor.
- 8. Email: The email address of the complainant.
- 9. Complaint Information: Details about the sexual harassment complaint including the name of the alleged harasser, description of the incident, dates, and witness information.
- 10. Signature: The signature of the complainant.
- 11. Date: The date the form was signed.
What happens if I fail to submit this form?
If you fail to submit this form, the incident may not be properly addressed or investigated. This can lead to continued harassment and potential legal implications.
- Continued Harassment: Without proper reporting, the harasser may continue their behavior, affecting you and others in the workplace.
- Lack of Documentation: Failure to submit the form means there is no official record of the incident, making it harder to take action.
- Legal Implications: Not reporting the incident may impact any future legal actions related to the harassment.
How do I know when to use this form?
- 1. Sexual Harassment Incident: Report any instance where you believe you have been subjected to sexual harassment.
- 2. Witness to Harassment: If you have witnessed an incident of harassment, use the form to provide details.
- 3. Retaliation Complaints: Report any retaliation you face after filing a previous harassment complaint.
Frequently Asked Questions
How do I fill out this form?
Start by providing your personal information, describe the incident, list any witnesses, and sign the form.
Can I edit this form after downloading?
Yes, you can edit the form using PrintFriendly's PDF editor before downloading.
How do I attach additional documents?
Use the PDF editor on PrintFriendly to attach any additional documents needed for your complaint.
Can I sign the form electronically?
Yes, use PrintFriendly's signature tool to sign the form electronically.
How do I share the completed form?
Use the 'Share' button on PrintFriendly to generate a shareable link for the completed form.
Do I need legal counsel to submit this form?
While not required, you may choose to provide legal counsel's contact information for assistance.
What happens after I submit the form?
The complaint will be investigated according to the District's sexual harassment prevention policies and procedures.
Can I report the incident verbally instead?
Yes, you can report the incident verbally, and the person you report to can complete the form for you.
Is my complaint confidential?
The investigation will be kept confidential to the extent possible.
Where can I find additional resources?
Visit the ny.gov website for additional resources on combating sexual harassment in the workplace.
