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Assessment of Concern Form for Students, Applicants, and Employees

Please note, submission of this form does not constitute an informal or formal complaint.

The purpose of this form is to provide an opportunity for individuals to convey employment-related concerns regarding allegations of discrimination, harassment, and/or employee relations. Persons who may find this method of communication helpful include, but are not limited to, applicants, faculty, and staff. Depending on comfort, this form allows an individual to disclose their identity or submit information while remaining anonymous. Once submitted, this form will be emailed to Mr. Joshua Hayes (Director, Title IX Deputy/Investigator, University ADA Services Coordinator – Equal Employment Opportunity/Affirmative Action/University ADA Services, also referred to as EEO) and Ms. Andrea Sherrill (Organizational Development Manager – Human Resources, also referred to as HR). Mr. Hayes and Ms. Sherrill will assess each submission and determine if the allegation(s) is/are relevant to the scope of this form. For any anonymous submission, a response may not be provided by an appropriate official. However, for any submission that is not anonymous, an appropriate official intends to be in contact with the individual who submitted the form.

Confidentiality will be observed to the extent permitted by law and consistent with protecting the welfare of students, faculty, staff, and interests of WKU. Although discretion will be exercised, confidentiality (or anonymity) may not be guaranteed as investigations normally involve communication and discussions with a number of parties. Every effort will be made to ensure information regarding an investigation is only conveyed to appropriate individuals. Because retaliation may be a reason an individual chooses not to share a report, please review WKU’s Retaliation Policy by clicking the following [forthcoming] link.

Western Kentucky University (WKU) is committed to a policy and practice of providing equal educational and employment opportunities to all individuals. In accordance with Title VI and VII of the Civil Rights Act of 1964, Title IX of the Educational Amendments of 1972, Section 504 of the Rehabilitation Act of 1973, Revised 1992, and the Americans with Disabilities Act of 1990, no form of discrimination or harassment will be tolerated at WKU on the basis of race, color, ethnicity, national origin, creed, religion, political belief, sex, sexual orientation, gender identity/expression, marital status, age, uniformed services, veteran status, genetic information, pregnancy, childbirth or related medical conditions, or physical or mental disability in admission to career and technical education programs and/or activities, or employment practices.

If you are seeking to file an HR related complaint, please email Ms. Sherrill at andrea.sherrill@wku.edu or call (270) 745-5360. If you are seeking to file an EEO related complaint, please email Mr. Hayes at joshua.hayes@wku.edu, call (270) 745-5121, and/or review WKU’s Discrimination and Harassment Policy (#0.2040) for assistance. Perspectives regarding the purpose of, and process for, filing an informal or formal complaint will normally be explained by Mr. Hayes unless circumstances require any modification or amendment to this process.

Affiliation with WKU (Not Required)

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 Last Modified 10/28/21