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HRHCR

Conestoga
 
Respondent’s Form - Human Rights Harassment/ Descrimination Complaint
 
Respondent's Name *      

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Position      
         
         
Other      

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RESPONSE TO ALLEGATIONS

With reference to the enclosed complaint, provide a detailed response to the allegations. In responding, please refer and respondto each allegation separately. The information that you provide should be as specific as possible with respect to dates, times,places, documents and persons involved.

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Please describe any actions that you have taken to try to resolve this matter.

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Provide copies of any documentation which may be relevant to the issues of this case as referred to in the complaint or in yourresponse. Please list the documents provided with comments where applicable.

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This document and any attachments to it that you provide in the course of responding to this complaint will be held in confidence by the College. Page one of this form and its attachments will be disclosed to the complainant and to the investigator, adjudicators and mediators appointed to assist with the resolution of this complaint, as outlined in the policy procedures. Privileged information, such as the list of witnesses, provided on page two of this form, will not be disclosed to the complainant. Your signature confirms that you have been made aware of and give permission for the above use of this information.
         
Signature of respondent   Date  
 
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Name *      

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Address      

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Telephone (Business)   Telephone (Residence)  
   
         
Email      

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Position held/work location      

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Witnesses to the events of this complaint:Please identify, in order of importance, anyone that you feel would provide helpful information to assist the investigation of thiscomplaint.
         
         
Name   Telephone  
   
         
Name   Telephone  
   
         
Name   Telephone  
   
         
Name   Telephone  
   
         
Signature of respondent   Date  
 
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Questionnaire received by   Date  
 
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Information gathered under this policy may be required to be disclosed under theOntario Human Rights Code or other legal proceedings.