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Proposal Form – Employment

  • The Proposal Form will let the other party know what you need to happen to resolve the complaint. The 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 more about the mediation process here.

  • • Why is resolving the complaint important to you?

    • What do you need to happen to resolve the complaint?

    • Focus on finding creative solutions to your problem.

    • Make sure you attach receipts and/or other documents to prove your claim.

    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.

  • You find this number on the Complaint Form that was sent to you.
  • Describe how your feelings, health, relationship with others, and etc. were impacted.

  • For example:

    • A Complainant who experienced harassment in the workplace received $5,000.00
    • A Complainant who was denied a job because of her gender received $7,000.00
  • For example:

    • A Complainant bought a special chair and a keyboard to use at work. It cost $350.00.

  • If you suffered lost wages, please answer the following questions to help calculate your loss:
  • Date Format: MM slash DD slash YYYY
  • Date Format: MM slash DD slash YYYY
  • For example, pay in lieu of notice or severance payment.

  • Date Format: MM slash DD slash YYYY
  • Briefly describe what you have done to limit the financial harm caused by the discrimination or harassment.

    For example, if you get fired, you have to make reasonable efforts to try to find another job so that you reduce your financial losses. This may mean taking lesser-paid work or expanding the job search area.

  • Drop files here or
  • The Human Rights Commission's mediator will review your Proposal Form. The following can happen:

    • You may need to provide further documents to prove your claim.
    • The mediator will calculate your proposed financial loss and help finalize the Proposal.
    • The final Proposal Form will be sent to the Respondent(s).
  • *This Proposal Form will be disclosed to the Respondent(s). Your personal contact information will not be given to the Respondent(s) or any person or 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 729-2709 or 1-888-563-5808.

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