UW EQUALITY WEBSITE > Application form about discrimination Application form about discrimination 1.Data of the reporting person First name and last name E-mail Affiliation (max. 150 characters) Sexwomanmannon-binary personnot listed aboveI prefer not to answer 2. Connection with the University of Warsaw studentPhD studentresearcher, scientific personnel or academic staffadministrationother (max. 150 characters) 3. What the event or series of events is the subject of: discrimination (a situation in which a person is treated in a biased and unjustified way usually less favorable due to a personal characteristic: innate - e.g. gender, age, sexual orientation or acquired - e.g. religion, belief)harassment (any, even a single-time, undesirable behaviour whose purpose or effect is to violate someone's dignity and create an intimidating, hostile, degrading, humiliating or offensive atmosphere towards him/her)sexual harassment (any, even a single-time, undesirable behaviour related to sex or gender, the purpose or effect of which is to violate the dignity of that person, in particular by creating an intimidating, hostile, degrading, humiliating or offensive atmosphere towards him or her – such behaviour may include physical, verbal or non-verbal elements)inciting discrimination (encouraging another person to violate the principle of equal treatment or ordering him or her to violate this principle, inciting others to behave in a way that discriminates against another person)unequal treatment (a situation in which persons in a given legal or factual situation, characterized by a specific feature to a comparable degree, are not treated similarly, and therefore according to the same measure, resulting in discriminatory or favouring differences or lack of this feature, are not treated appropriately differently)hate speech (negative statements - verbal or non-verbal - addressed to a specific individual/group due to their characteristics, e.g. nationality, skin color, sexual orientation, expressing intolerance towards differences, promoting harmful stereotypes and aiming at degrading treatment of others)I'm not sure/other (max. 350 characters) 4. Do you think the event/series of events was motivated by any of the following: disability/health conditionsexual orientation (feeling emotional and sexual drive, creating close and intimate relationships with people of the same, different, both or neither sex)gender identity (gender identification, self-perception and self-definition, sense of belonging to a specific gender, internal sense of "self" as a man, a woman, a combination of both concepts or neither of them)sexrace/ethnicity/national originreligion/faithworldview/political beliefsagepregnancy, motherhood, parenthoodmarital statustype of employment (e.g. fixed-term contract, part-time contract, flexible working arrangements)I don't think this incident was motivated by any of the above featuresother (max. 350 characters) 5. Description of the incident(s) (max. 2500 characters) 6. Where the incident/the last in a series of incidents took place (multiple selection possible) at the University of Warsaw (e.g. lecture hall, library, canteen, laboratory, PE hall, toilet)in a student dormitory belonging to the UWduring a trip related to work/study at the UWoutside the University of Warsaw - in a place not related to work and studies at the UWin a virtual space, including an online meetingin none of the above places Where? (max. 350 characters) 7. When the incident/the last in a series of incidents took place less than a year ago - until todaya year ago - until three years agomore than three years ago 8. Was anyone present during the incident? noI don't know/I don't remember/I prefer not to answeryes Who? (max. 350 characters) 9. Do you have evidence documenting the incident (recordings, photos, e-mails) noI don't remember/I don't knowyes (max. 500 characters, general description of what it is, at this stage, without attaching evidence - for information purposes only) 10. Has the incident been reported to any institution/unit yet? noyes UW internal unit: Academic OmbudsmanEquality Team of the University of WarsawAnti-unequal treatment and discrimination Commission/ Anti-mobbing and other undesirable behaviours CommissionOffice for Persons with DisabilitiesPsychological and Counselling Services Centre (CPP)Centre for Conflict and Dispute Resolution at the Faculty of Law and AdministrationAcademic Legal CounsellingEquality Plenipotentiaries at facultiesStudents’ CouncilStudent Ombudsman Team/Consultation Team on sexual harassment by Student Ombudsman Teamother What? (max. 350 characters) unit from outside the University of Warsaw: NGOs (foundation or association - e.g. PTPA – Polish Society of Anti-Discrimination Law, Feminoteka - foundation helping women experiencing violence Association for Legal Intervention)Public Prosecutor's OfficePoliceother What ? (max. 350 characters) other (max. 350 characters) Information about the processing of personal data
