University of Mississippi Workplace Issues Reporting Form
This is a space for workers at the University of Mississippi to report mistreatment by supervisors or other workers to the United Campus Workers of Mississippi (United Campus Workers - Communication Workers of America, Local #3565). Any information you provide will be kept strictly confidential and you have the option to report feedback anonymously.

Part of our goal is to begin to compile a list of issues that our workers face and be able to uncover systematic patterns of behavior. If you would like a member of the steering committee to contact you, please provide some contact information in the spaces provide below so that we can follow-up with you.

Other resources you may also consider include:

University Ombuds (,, 662-915-1537
University Counseling Center (,, 662-915-3784
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Please provide a narrative describing the workplace situation of concern. *
Would you like a member of the union to follow-up with you? *
Phone number
Preferred method of contact
Clear selection
The remaining questions are optional, and will only be used for the purposes of gathering data on issues that workers face.
What unit/department do you work in on campus?
What is your position on campus?
What race/ethnicity do you identify with?   (select all that apply)
What pronouns do you use to identify yourself?
Clear selection
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