Anonymous or Voluntary Incident Reporting Form
This form is for individuals who wish to confidentially report an incident, to limited members of the Chapter leadership. 

How is the information submitted through this form used?
With the information provided through this Anonymous or Voluntary Incident Reporting Form, the Chapter leadership can:
  • connect reporting persons (or others involved) to resources, when feasible and appropriate; 
  • maintain an accurate record of the number, type, and location of incidents affecting the Gotham community;
  • determine if our current policies are adequate to provide all members of our community a sense of safety and community at all of our events;
Please describe what happened: *
When did this happen? *
MM
/
DD
/
YYYY
Where did this happen? *
Is there anyone who was a witness to the incident? If so, please list any and all names. *
Your name (optional)
Your email (optional)
A member of leadership will contact you to follow up about this incident should you provide your email address.
Do you wish to remain anonymous? *
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