Bullying and Harassment Agreement
Please review and acknowledge your understanding and agreement with our anti-bullying and harassment policies.
Full Name
*
First Name
Last Name
Email Address
*
example@example.com
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Department / Unit
*
Position or Role
*
Have you received training on bullying and harassment prevention?
*
Yes
No
Do you know how to report incidents of bullying or harassment?
*
Yes
No
Have you witnessed or experienced any bullying or harassment in the past 12 months?
Yes
No
Prefer not to say
Please acknowledge that you have read and understood the organization's anti-bullying and harassment policy.
*
I acknowledge and understand the policy
I need more information
I agree to comply with the organization's anti-bullying and harassment standards.
*
I agree
I do not agree
Comments or concerns (optional)
Signature
*
Submit Agreement
Submit Agreement
Should be Empty: