Human Rights Request for Resolution & Incident Reporting Form
This form is to be used to request the support of the WRDSB Human Rights Branch in resolving a complaint/issue/matter of discrimination or harassment that is believed to contravene the Ontario Human Rights Code (the Code) and Waterloo Region District School Board Policy 1017 - Human Rights.

Not all unfair treatment and harassment is covered by the Code or Board Policy 1017; the code applies to harassment and discrimination based on the protected grounds only: age, ancestry, colour, race, citizenship, ethnic origin, place of origin, creed, disability, family status, marital status (including single status), gender identity, gender expression, record of offences (in employment only), sex (including pregnancy and breastfeeding), and sexual orientation.

The information submitted in the reporting form will be received and retained by the Human Rights Branch and will not be shared with any other department or unit within the WRDSB. The Human Rights Branch will endeavour to respond to all completed reporting forms within five (5) working days.

After submitting this form, the Human Rights Branch will follow up confidentially to determine next steps. Please note that submitting a reporting form does not begin a formal complaint resolution process or guarantee that any specific action(s) will be taken by the Human Rights Branch.

Managers, Administrators and Superintendents may also use this form to refer a complaint to the Human Rights Branch following early or site-based resolution attempts or to request additional support.

  • Please note, where the concerns have been the subject of any of the following processes, the formal complaint resolution process will not be used to respond to the complaint (AP1210 Section 15.2/AP1215 Section 14.2):

    • A complaint/grievance/arbitration process of a Union/employee association 

    • An active/closed disability management claim 

    • an active/closed non-occupational illness claim 

    • A matter that is being addressed through an active/closed provincial Board/tribunal

    • A matter is being addressed through the judicial/criminal justice system,

    • A matter, in the view of the Board, is vexatious and/or has been filed in bad faith”

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Email *
First Name *
Last Name *
Phone
Preferred Contact Method? *
Your role and/or connection with WRDSB (as is most relevant to this report) *
Required
Union/Association Affiliation (if applicable) *
Required
What best describes your reason for making this report? *
Required
Have the concerns been the subject of any of the following processes? *
Required
Please provide a brief summary of your concerns relating to harassment or discrimination. Include any relevant date(s), location(s), and names of other parties involved.   *
Please select the relevant Human Rights Code protected grounds that are relevant to your concerns (select all that apply): *
Required
Please provide the names of staff, managers or others with knowledge or information about your concerns . *
Please describe, if any, steps that you have taken to address the situation.
Please share any other relevant information here.
A copy of your responses will be emailed to the address you provided.
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