Public Interest Disclosure Form (PIDA)

What is PIDA?

The Public Interest Disclosure Form (PIDA) is a form is designed to assist you with providing information about how to disclose a serious wrongdoing to your supervisor, or designated officer. The information provided on this form will help facilitate review of the matter under the Public Interest Disclosure Act. If you are unable to include all details about the alleged wrongdoing on this form, you may submit further details as a separate document. Please include it when you submit this form.

The designated officer will review the information you provide while taking strict measures to keep your identity confidential. A team trained in processing PIDA disclosures will review the information you provide while taking strict measures to keep your identity confidential. If additional information or clarification is required, the designated officer will contact you directly.
Questions marked with an * are required. Disclosures under PIDA cannot be assessed without these completed fields.
1.*Indicate if the alleged wrongdoing is about:
On the envelope: If the alleged wrongdoing is about the Superintendent mark it for the attention of the Secretary-Treasurer. If it is about the Secretary-Treasurer mark it for the attention of Superintendent. If it is about both of them mark it for the attention of the Board Chair. All other disclosures mark for the attention of the Executive Director, Human Resources.

All reports will be considered in a timely and fair manner.
2.*Are you a member of the public, meaning never been employed by the school district? If yes, go to question 5.
3.*Are you an employee of the school district?
4.*Were you an employee of the school district when the alleged wrongdoing occurred or was discovered?
Type of wrongdoing
5.*The alleged wrongdoing I wish to disclose related to: (Please check one or any that apply)
If none of the above apply, the Public Interest Disclosure Act may not be the best way to raise your concern. Please consider addressing the matter by contacting your supervisor for guidance.
While anonymous disclosures may be accepted under the PIDA, we may not be able to investigate it if we are unable to contact you to confirm you are a current or former employee to obtain further details, evidence or clarification about your disclosure.
6.*Do you wish to submit this disclosure anonymously?
Contact Information
Please enter your contact information below so that we can communicate with you about your disclosure. Your identity and contact information may be shared with investigators to allow them to communicate with you.
7.First Name
8.Last Name
9.Street Address
10.Unit Number
11.City
12.Postal Code
13.Province
14.Daytime Phone Number
15.Other Phone Number
16.Email Address
17.May a message be left at your daytime phone number?
Disclosure Details
*In the space provided below, please provide as much information as you can about the alleged wrongdoing and the person(s) alleged to have committed the wrongdoing. The following details are required, if known:

Description of the wrongdoing and any relevant background

The names of those responsible

When and where the wrongdoing occurred

Names of people who witnessed some or all of the wrongdoing, if available.
18.Disclosure Details
If space is not sufficient, please include additional documents. Retain copies of all your submissions. Please note, you do not have to provide supporting materials.
Steps Already Taken
19.*This section helps us understand what steps have already been taken to prevent to alleged wrongdoing. Have you reported the wrongdoing to your supervisor, the Executive Director of Human Resources, another excluded manager or through another process?
20.*Are you aware if other bodies are investigating the wrongdoing (e.g. grievances through bargaining unit?)
21.If yes, please specify the body looking into the wrongdoing, that status, and/or any responses received.
Find out more about making a Public Interest Disclosure by visiting our PIDA webpage.