Support Fund for Racialized Members who Experience Discrimination, Harassment, and Violence.
Name as it appears on the Membership list
First Name
Last Name
Preferred Name (if different from above)
First Name
Last Name
York Employee ID
Email (Non-York preferred)
example@example.com
Phone Number
Please enter a valid phone number.
Which Unit are you apart of?
Unit 1
Unit 2
Unit 3
Unit 4
Unit 5
Hiring Unit
ie. Social Science, AMPD, etc.
End date of most recent CUPE contract
-
Month
-
Day
Year
Date
Total Amount Requested
Itemized list of relevant expenses (to the extent possible)
Upload any relevant financially-related documentation
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Rationale for application
Staff person working with my complaint (please note that the details of your complaint will be kept confidential and will only confirm that a complaint/grievance has been filed)
Please Select
Julian Arend
Raj Virk
Nadia Kinani
To the best of my knowledge, I certify that all information presented herein is accurate.
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