Workplace Issues
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First Name *
Last Name *
Pronouns
Contact Info *
Submitted on behalf of *
Workplace Department *
Academic Department *
Position *
Please check any areas in which you may be experiencing violations of your contractual rights
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In your own words, tell us about the details of the issue. For example, you can elaborate on: who, what, when, where, why?
Is this complaint time-sensitive? Checking this box will alert the committee of a high-priority submission
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I prefer to speak to a representative that identifies as: (gender, orientation, international, etc.-- please keep in mind that this depends on staff/volunteer availability, but we will try to accommodate this request to our best ability)
Preferred language (please keep in mind that this depends on staff/volunteer availability, but we will try to accommodate this request to our best ability):
If you selected "Other/Not Listed," please indicate your preferred language here (please keep in mind that this depends on staff/volunteer availability, but we will try to accommodate this request to our best ability).
Do you have any additional comments, concerns, or preferences?
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