Email

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■People who can consult/report
Please tell us about you who would like to consult / report.It is mandatory to fill in your name, but you can choose to be anonymous when we contact a external contact (NEC VALWAY)・University （compliance promotion office）.

【Mandatory】Your department：Undergraduate student / Graduate student / Faculty, Researcher, Assistant Professor, Research Associate / Staff, temporary staff, group company employee / Families of student / faculty member / Graduates (including withdrawals), retirees / Others

【Mandatory】Affiliation name：
　*In the case of an undergraduate, a postgrad, please input a department or a graduate course and the school year. If you are a faculty member, please enter your affiliation.

【Mandatory】Notification to university(compliance promotion office)： Make it anonymous / Use your real name (Name:　　　)
　*If you would like to be supported by a university, in principle, please consult with your real name. In the case of anonymity, the response by the university is general and the effectiveness cannot be guaranteed.

【Mandatory】Disclosure of your name to the external contact ： Make it anonymous / Use your real name (Name:　　　)

【Mandatory】Share consultation statement contents with relevant departments or faculty you belong to
*Please let us know if you are comfortable sharing your name and the details of your consultation with the department or graduate school (executive office/office management and the person in charge) of the department/actor involved in order to resolve the problem.
Please choose one of the following:
・All can be shared：Share both the personal information of the consultant (affiliation, name, contact information) and the “details of the consultation/report (Chapters 2 and 3).
・Can be shared in part：Only the content of consultation/reporting (Chapter 2 and 3) can be shared.
・Can be shared in part：Can be shared except for the following. Please write down the following questions that cannot be shared.
・All cannot be shared：Do not share either the personal information of the consultant (affiliation, name, contact information) or the “contents of consultation/reporting (Chapters 2 and 3)”.
If you select the third option,
Please write what you do not allow to be shared with related parties：

〇Contact Information
Please enter your email address so that we can send you a notification of acceptance.

【Mandatory】Email address：
*You will automatically receive a notification that your application has been accepted.
*If you are using a domain-specified receiving system,please enable your account to accept messages from "@list.waseda.jp"”@dmsig.jp.nec.com" in advance.

The University (compliance promotion office, relevant departments, faculty you belong to, etc.) might, as necessary, contact you at the contact information you have provided, in order to ask more details about your consultation.

【Mandatory】Contact Information：E-mail / Unnecessary

<If you prefer to send us an email>
We will contact you at the email address you entered above.
*If you wish to consult anonymously, please enter an email other than the Waseda domain email.

■Contact information
If you wish to receive a reply or correspondence within 2 days after your consultation (except for university holidays, including Saturdays, Sundays and national holidays), please indicate so in the remarks column.
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■What happened?
We will report what you entered directly to the university

〇Types of our services
【Precautions】
①Depending on the content of the consultation, we may contact the person making the report/consultation to ask for more information about the situation and their wishes.
②If the consultation content does not fall under the selected content, it may be treated as a corresponding consultation/report type.
③～ To students ～
Please consider consulting with your affiliated office regarding matters related to your studies, such as course registration (including selecting or changing seminars), classes, exams, grades, thesis/research guidance (including changes to supervisors), student status (leave of absence, studying abroad, withdrawal, etc.), scholarships, etc.

Depending on the content of the consultation,they will contact the person who made the notification or consultation, and ask the person who consulted about the details of the situation and their intentions.

【Mandatory】Content of consultation：Problems in class or research guidance / Problems in non-academic aspects of university life (extracurricular activities etc.) / Harassment / Whistleblowing / Research wrongdoing: Improper actions taken during research activities / Other: Opinions / complaints / except for the above

〇What do you wish to file a report or consult about?
Please tell us about the problem by giving a detailed description of ‘What happened’ and ‘Who did it.’

【Optional】Occurrence time：

【Optional】Occurrence place：

【Optional】Recognition time：

【Mandatory】Details of whistleblowing / consultation：

【Mandatory】Request to the university：

【Mandatory】Recognition of the surroundings：Yes / No

【Mandatory】Evidence：Yes / No
*The evidence will be submitted to the university as it is.
*If you wish to remain anonymous, please make sure that your information is not included.

■Who did that?
Please tell us about someone who has done or seems to have done something you consider problematic.
If you don’t enter, we may not be able to investigate.
If the harassment actor is not recognized as a member of the University, we can consult with you, but please be aware that the effectiveness is extremely low.

【Optional】Actor classifications：Undergraduate student / Graduate student / Faculty, Researcher, Assistant Professor, Research Associate / Staff, temporary staff, group company employee / Families of student / faculty member / Graduates (including withdrawals), retirees / Others

【Optional】Affiliation name
*In the case of an undergraduate, a postgrad, please input a department or a graduate course and the school year.
If you are a faculty member, please enter your affiliation.

【Optional】Name

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