Sexual Harassment Complaint Form
ADVERTISEMENT
1Sexual Harassment Complaint Form
Employee Name: ___________________________
Date: __________
Department/School: ____________________________________________
Who was responsible for the harassment? __________________________
Describe the harassment: ________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
Harassment occurred: Date: ______________
Time: ______________
Place: _______________________________________________________
List any witnesses to the harassment: ______________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
What was your reaction to the harassment? __________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
I agree that all the information on this form is accurate and true to the best of
my knowledge.
Signature: ___________________________________ Date: __________
HRD06 8/09
~An Equal Opportunity School District ~
ADVERTISEMENT
0 votes
Related Articles
Related forms
Related Categories
Parent category: Legal