Belleville Theatre Guild Incident Report Form

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Belleville Theatre Guild Incident Report Form

Please use this form to report all theatre-related incidents, including, but not limited to, instances of alcohol or drug use, discrimination, harassment, theft, violence, injury and other persistent forms of conflict and difficulty. This helps our board of directors to identify and correct problems as they arise. This form is sent directly to the BTG Board of Directors. Any information you share will be kept confidential. This form should be completed and submitted as soon as possible after the incident has occurred.

Your Name *

Date of Incident *

YYYY

Time

Time

Nature of Incident *

General, harassment, injury, etc.

Details of the Incident *

Provide as much detail about the situation as possible. Provide names (when possible) of those involved and the location where the incident took place.

Would you like to be contacted by a board member regarding this incident? *

Yes

Required

If you would like to be contacted, please provide contact information here.

Submit

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