Violation report card at the University of Silesia in Katowice

In order to submit a report, fill out the form below, enter the verification code displayed in the image at the bottom of the form and then press the "send" button.

We encourage you to prepare the content to be placed on the form in advance, so that it can be completed in a few minutes.

1. Reporting person’s information

Name and surname

Determining the relationship towards the University employee a person providing work on a basis other than an employment relationship, including on the basis of a civil law contract (e.g. contract of mandate, contract for specific work) a person who has worked for the University in the past intern, volunteer student, PhD student, auditor graduate a person cooperating with the University as a subcontractor or supplier

Email address

Phone number

The Reporting Person expresses the will for the report to be made
(does not apply to cases where the obligation to disclose the identity of the reporting person results from generally applicable provisions of law) public (the reporting person agrees to disclose their identity to those involved in the investigation of the report) confidential (the reporting person does not agree to the disclosure of their information and the information is kept secret)

2. Victim’s information (complete if reporting in the interest of a third party)

Name and surname

Position

3. Has the report been consulted with the victim?

No Yes

4. The entity whose act or omission the report concerns

Name and surname

Position

5. Description of the reported violation

please indicate whether the violations took place on the premises of the University, if so, where exactly, please specify the dates of the events. If the violation concerns a long-term situation, please specify the starting period and the ending period, unless the situation is still ongoing.

Description of the reported violation

6. Evidence of the violation, if known to you

7. Has the violation been previously reported?

No Yes

Specify when, to whom and in what form violations were reported, and whether a response to such a report was received.

8. Additional information on reported violations

Verification code

The role of the verification code is to make it difficult to fill in the form in an automated manner by computer programmes. Please enter the code from the picture into the form field below. In case the image is illegible, clicking on it will generate a new string of characters.

Verification code

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