Grievance Incident

All Greenheart employees and cultural exchange stakeholders (participants, hosts, local coordinators, or other representatives) are encouraged to promptly report incidents about harassment, racism and/or discrimination. Employees and/or cultural exchange stakeholders found to be in violation are subject to corrective action up to and including termination of employment, program or partnership should behavior persist or in cases where harm was intentional. Racist/discriminatory remarks by anyone, including managers, coworkers, vendors, independent contractors or customers of Greenheart International will not be tolerated.

Name of the Grievant:*

Department/Program:*

Affiliation with Greenheart:*

Phone Number:*

Email Address:*

Name of the Accused:*

Department/Program:*

Hidden

If there is any physical evidence that supports your grievance? If so please attach a copy of the evidence here.

Accepted file types: jpg, gif, png, pdf, Max. file size: 6 MB.

Relationship of the Accused to the Grievant:*

Phone Number:*

Email Address:*

Date of the Incident:*

(If more than one event, please report each event on a separate form)

Where did the specific event occur?*

Please explain the events that occured:*

How did you react to the situation? Did you take any action to stop the perceived inappropriate behavior?*

Describe how this event/incident impacted you:*

Were there any witnesses to this specific event? If yes, please provide names.*

Is there any physical evidence that supports your grievance? If so, please describe or attach a copy of the evidence.*

What is your desired outcome of this investigation?*

The information provided in this grievance/incident report is true and correct to the best of my knowledge. I am willing to cooperate fully in the investigation of my complaint and provide whatever evidence Greenheart International deems relevant. Submission of this form will be directed to HR, President and Vice-Presidents. All situations and circumstances will be handled discreetly when possible and always on a case-by-case basis.

Consent*

I agree to the above statement.

Grievance Incident

Grievance Incident Form