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Timetabling Tiers Tool Form

This form is for submitting Tier 1B, Tier 2A and Tier 2B requests.

The content of this form will remain confidential to the person to whom it is originally submitted and to those individuals who are consulted in this process, namely the Faculty Relations Office and the Manager of Return to Work and Accommodation Services (if applicable), as well as the Head and the Dean or Dean 91��Ƭ�� ’s delegate.

The Dean or Dean 91��Ƭ�� ’s delegate, supported by the Faculty Relations Office, may request additional information from the Member in establishing whether accommodation is required pursuant to the Human Rights Code. The Dean, or Dean 91��Ƭ�� ’s delegate, shall provide their decision regarding the Member 91��Ƭ�� ’s request directly to the Member with a copy to the Head in a departmentalized faculty.

Name

Department

Please select the tier that applies to your request:

Tier 1B: “based on an enumerated ground in the Human Rights Code other than disability.”

Tier 2A: “based on membership in an ‘equity-seeking group’ (as defined by Section 24 of the Collective Agreement.”

Tier 2B: “based on research, or other academic, responsibilities”

State your requested timetable accommodation:

(e.g. can only teach after 10am or cannot teach on Mondays etc.)

Provide reasons for this request:

Describe how the basis of your request has a direct connection to your need for this timetable.

Agreement

By submitting this form you acknowledge and agree to the above statements:

Agree