Human Rights Reporting Form

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** Please note that due to a high volume of requests, there will be a delay of approximately one to two weeks in responding to this form. If you need more immediate support, please contact the Administrative Assistant to the Office of the Human Rights and Equity Advisor, Kim Young at kim.young@ocdsb.ca and she will direct your concern to someone who can provide more immediate support.

This form is modeled on a form developed by the Human Rights Commissioner's Office at York Region District School Board.

Email *

First Name *

Last Name *

Preferred Name

Pronoun

Email Address *

Phone Number

Your role and/or connection with OCDSB (in relation to this issue) *

Grade and Name of School (if applicable)

Union/Association Affiliation (if applicable)

What best describes your reason for making this report? *

Date of incident/issue

YYYY

Place where incident/issue occurred *

Human rights ground(s) affected *

Age

Ancestry (including Indigeneity)

Citizenship

Colour

Creed (religion)

Disability (including mental, physical, developmental or learning disabilities)

Ethnic origin

Family status (such as being in a parent-child relationship)

Gender expression

Gender identity

Marital status (including married, single, widowed, divorced, separated or living in a conjugal relationship outside of marriage, whether in a same-sex or opposite-sex relationship)

Place of origin

Race

Record of offences (criminal conviction for a provincial offence, or for an offence for which a pardon has been received)

Sex (including pregnancy and breastfeeding)

Sexual orientation

Socioeconomic disadvantage

Other reason

Required

Please provide a brief summary of your concerns relating to harassment, discrimination or other human rights issue. Include any steps you’ve taken to address the concerns. *

Please provide the names of other people involved. *

Please provide the names of all other people at the OCDSB who have knowledge of this matter. *

Is there another person or department in the OCDSB who has reviewed this matter? *

Is there another person or department in the OCDSB who is currently reviewing this matter? *

How did you learn about the Office of the Human Rights and Equity Advisor? *

Send me a copy of my responses.

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