ACKNOWLEDGMENT OF RECEIPT OF
XAVIER UNIVERSITY’S HARASSMENT CODE
AND
ACCOUNTABILITY PROCEDURES
I acknowledge the receipt of Xavier University’s Harassment Code and Accountability
Procedures.
I agree to abide by the rules and procedures as outlined in this policy on harassment and
accountability procedures and understand that I will not be penalized in any way for reporting
conduct that I reasonably believe to be forbidden by this policy.
Received:
__________________________________________________
Employee Name (print)
___________________________________________________
Employee Signature
___________________________________________________
Date
Revised 08/24/11
Harassment Acknowledgement.doc