BIAS INCIDENT REPORT
A bias incident refers to behavior that is hostile, harassing, intimidating, offensive or discriminatory based on actual or perceived protected classes such as race/ethnicity, religion, gender and/or disability.  Please complete this form if you have been a victim or have witnessed a bias incident that needs to be reported to the School District of Cudahy.  
Sign in to Google to save your progress. Learn more
Today's Date *
MM
/
DD
/
YYYY
School you are associated with *
I'm a *
If a student.  What grade are you in? *
What gender do you associate with? *
I am/was a *
Type of bias incident: *
I believe that the bias incident was motivated by: *
Name(s) or description(s) of the person(s) involved. *
Describe the bias incident. *
Location of the bias incident. *
When did the bias incident occur? *
Please click on this link if you have supporting documents that you wish to upload.  
How would you like us to follow up? *
Follow up information, if applicable. *
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of School District of Cudahy. Report Abuse