A Better CPTC
Bias, Discrimination, Harassment, Intimidation, Bullying, and Retaliation
Type of Concern
---- Select Concern ----
Bias
Discriminatory Conduct
Harassment
Intimidation
Bullying
Retaliation
Lewd Conduct
Online Harassment
Sexual Misconduct
Describe Concern
Date Occurred
Time Occurred
-Hours-
1
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-Minutes-
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-AM/PM-
AM
PM
Location
Enter the names of any individuals you suspect were involved or witnessed the behavior
Full Name 1
Full Name 3
Full Name 2
Full Name 4
Occurred Before
-- Select Value --
Yes
No
Reported to CPTC
-- Select Value --
Yes
No
Select the best method to contact you and provide contact information
Your Full Name
Please Call
Phone Number
-- When "Please Call" is selected a number is required --
Please Email
Email Address
-- When "Please Email" is selected your email address is required --
Remain Anonymous
Create a password to login and access the current status of this concern
Your Password
Attach File 1
Attach File 2
Once this form is submitted, the Associate VP of HR and/or the Assistant Director of HR will review the form to determine next steps and if an investigation is warranted.
