Statement Submission Form - SF DCCC - Sexual Assault and Harassment in the San Francisco Political Community, Special Committee

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

Statement Submission Form - SF DCCC - Sexual Assault and Harassment in the San Francisco Political Community, Special Committee - May 2, 2024

This is for the Collection of Information, in addition to statements provided on Agenda Item 3 and Item 4 at the May 2, 2024 meeting. The purpose of the Collection of Information is for the Special Committee to hear from survivors, witnesses, and providers; and, to understand the scope of the problem of sexual assault and harassment in the SF political community.

This form can be filled out by survivors, witnesses, and providers.

These statements may be anonymous at the submitter’s discretion. Statements will not be posted nor made public. Anonymous statements will be shared only with Special Committee members.

This Statement Submission Form will remain open until June 30th.

---------------------

From the Agenda:

Item 3. Public Collection of Information (Discussion and possible action)
The Committee will hear statements from the public on the topic of sexual assault and harassment by members of the Democratic political community.

Item 4. Closed Session Collection of Information (Discussion and possible action)
The Committee will hear statements from the public in closed session in order to protect the privacy of individuals.

Meeting Guidelines and Procedure

Date of incident, or, timeframe of issue:

Please share your story.

Please include specifics if applicable, such as the type of event function, sponsoring organizations, names of people involved, ect.

Did you report this incident/issue?

If so, please share who/where you reported the incident/issue to, and what type of response you received. If you did not report the incident/issue, please explain why not.

What is your hope or goal in sharing this story with the Special Committee?

Name:

(Sharing your contact information is optional. We respect your desire if you wish to remain anonymous.)

Email:

(Sharing contact information is optional. We respect your desire if you wish to remain anonymous.)

Phone number:

(Sharing contact information is optional. We respect your desire if you wish to remain anonymous.)

Can we contact you for a follow-up conversation?

Submit

Clear form

Never submit passwords through Google Forms.

This form was created inside of Lily Ho for DCCC 2024. Report Abuse

Forms