John Cabot University DISCRIMINATION/HARASSMENT COMPLAINT FORM John Cabot University is committed to being an academic community that values mutual respect, human dignity and individual differences, and that is supportive of intellectual, personal and professional growth. As such, the members of the JCU Community have the right to an environment free of discrimination and harassment. Discrimination: when an individual or group is treated less favorably than others because of race, religion, ethnicity, national origin, gender, age, marital status, familial status, disability, economic status, or sexual orientation or reassignment or any other factor(s) unrelated to ability or potential. Harassment: Unwanted conduct or speech violating a person’s dignity, creating an intimidating, hostile, degrading, humiliating or offensive environment, that interferes with the learning, work or social well-being of all members of the JCU community, is prohibited. Harassment includes the following: Sexual harassment: unwelcome sexual advances, requests for sexual favors, and other verbal or physical conduct of a sexual nature. Sexual harassment includes: Unwanted sexual statements: such as jokes, comments on physical attributes, spreading rumors or talking about or rating others’ sexual activity or performances. Unwanted personal attention: such as letters, phone calls, texts, visits, pressure for sexual favors or unnecessary personal interaction, with an evident sexual or romantic intent. The unwanted character of such personal attention can be inferred by its aggressive nature, or its persistence even after the object of this attention has expressed that it is unwanted, and will be implied where there is a power asymmetry between the subject and object of this attention (such as that between an instructor and a student, or a supervisor and a worker). Unwanted physical or sexual advances: such as unwanted touching, hugging, kissing, fondling, touching oneself sexually for others to see or other sexual activity. Gender-based harassment: includes acts of verbal, non-verbal or physical aggression, intimidation or hostility on the basis of sex or sex-stereotyping (such as sabotaging female students’ work, heckling a student because of his or her sexual orientation or gender identity). Bullying: repeated or persistent action, criticism or abuse in public or private which (intentionally or unintentionally) humiliates, denigrates, undermines, intimidates or injures the recipient. Setting up a person to fail, ridicule, exclusion, victimization, unfair treatment, misuse of power. Hate Speech: consists of highly derogatory or grossly degrading speech that is intended to dehumanize, humiliate or incite hatred against persons or groups, because of their race, religion, gender, sexual orientation or disability. Students may consult with and return this form to the Office of Student Conduct, Health and Well-Being (conduct@johncabot.edu). Staff may consult with and return this form to Kathryne Fedele, Chief of Staff (kfedele@johncabot.edu). Faculty may consult with and return this form to Mary Merva, Academic Dean and Vice President (mmerva@johncabot.edu). Any member of the JCU Community may consult with and return this form to Elaine Luti, JCU Counselor (eluti@johncabot.edu). Please note that the University will take the necessary steps to protect the privacy of the parties involved. However, by signing this form the complainant waives his or her right to confidentiality. Acts of retaliation (punishing, either overtly or covertly, or taking negative actions to deter) a complainant for making discrimination or harassment complaints or participating in discussions of such will not be tolerated by John Cabot University. Intentionally false allegations/accusations are likewise considered malicious and will not be tolerated. ***************************************************************************** Please provide the following information, and feel free to add an additional sheet: Your name: ___________________________________________________________________ Email address and/or phone number: _______________________________________________ Describe in as much detail as possible what happened (attach additional sheets if necessary). Make sure to include: 1) The names of all parties involved and their relationship to you; 2) Specific dates, times and locations; and 3) The names of any witnesses to the event ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ What would you consider to be a successful or acceptable outcome and/or resolution to your complaint? ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ What might you need in order to feel safer while your complaint is being examined? ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ I certify that this information is correct to the best of my knowledge. ___________________________________________________________________/____/_____ Signature Date