Form Builder

People Involved

* Please note that we need the full names of the people involved in order for processing.

Who are you?

First and last name + grade and class

Your email address

We will send you an email confirmation that we have received your message.

Who saw or experienced the instance of discrimination?

First and last name + grade and class

Were there additional witnesses?

First and last name(s) + grade and class

Person(s) accused of discrimination

First and last name(s) + grade and class

What happened?

Brief description of what took place, where, and when

Have any steps been taken in response?

If so, what?

Requests for further action

For example, you can also write whether you would prefer that no further action be taken (passing on the information via this platform is enough), or whether you would like to remain anonymous in the further processing.