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Human Rights Application Form

  • Thank you for contacting the Newfoundland and Labrador Human Rights Commission. We will review your completed Application Form and decide if we can accept a complaint. We will notify you of our decision.

    There is no cost to fill out the Application Form.

  • The Application Form is simple to understand and easy to use. You can fill it out on your own or get help from family, friends or a support person.

  • Before you start:

    • Read the Application Form and the Complaint Resolution page on our website first.

    Fill out all fields marked with an asterisk (*).

    You will not be able to save this document. Fill it out all at once or answer the questions in a separate word document and then cut and paste your answers back into this Form.

  • We ask this information so we can address you respectfully through this process.

  • We ask this information so we can address you respectfully through this process. This is for internal use only.

  • Using accommodations and/or supports will not affect your application or be disclosed to anyone outside of our office. You will be treated the same way whether or not you ask for any accommodations and/or support. We will make every attempt to provide reasonable accommodations and/or support. This is for internal use only.

  • This information is for internal use only.

  • This information is for internal use only.

  • This information is for internal use only.

  • This information is for internal use only.

    • Check your paystub, T4, rental agreement, contract or company website for the official name.
    • Find more information about how to find the correct name here
    • Name of company, business, organization, association or person.
    • Check your paystub, T4, rental agreement, contract or company website for the official name.
    • Check your paystub, T4, rental agreement, contract or company website for the official name.
    • Learn more about why the discrimination or harassment must happen in Newfoundland and Labrador here
    • Learn more about the one-year limitation period here
  • Date Format: MM slash DD slash YYYY
    • For definitions refer to our FAQ.
  • Answer ALL of the following questions:

    • Who was involved (include names) in the incident?
    • Did it happen once or is it still ongoing? (list dates if necessary)
    • Were there any witnesses?
    • Find examples of how to fill out this section here
    • Mediation is a quick and easy way to solve problems. There is no cost to go to mediation.
    • Find out more about our mediation process here
    • For example: job advertisement; T4 or ROE Forms; letters, emails from your employer; rental agreement; contracts, etc.
    • Learn how to attach documents here.
    Drop files here or
  • The Human Rights Commission will review your Application Form and decide if we can accept your complaint. One of three things will happen:

    • Your application can be accepted as a complaint. A copy of the complaint will be sent to the person you are complaining about; or
    • We need more information to make a decision; or
    • Your Application Form cannot be accepted as a complaint. You will get written reasons for our decision.
  • *If your complaint is accepted, and you agree with moving forward with the process, the content of this Application Form will be shared with the Respondent. (Respondent is the person who you are complaining about.) Certain personal information will not be given to the Respondent or any other person/organization outside the Commission, unless required by law (e.g. Access to Information and Protection of Privacy Act.)

    The collection and disclosure listed above is authorized under sections 61(c) and 68(1)(b) of the Access to Information and Protection of Privacy Act, 2015.

    If you have any questions regarding this collection or disclosure please contact the Human Rights Commission at 1-709-729-2709 or 1-800-563-5808.

  • This field is for validation purposes and should be left unchanged.