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Community Incident Reporting Form
Date of Incident
*
Time of Incident
*
Location of Incident
*
Location of Incident
Description of Incident
*
Type of incident
*
Type of incident
Harassment
Discrimination
Bullying
Unwanted Contact
Other
(optional) Who was involved
(optional) How did the incident affect you?
(optional) Did you report this incident to someone?
(optional) Would you like to be contacted about this report?
(optional) What would you like to see done in response to this incident?
(optional) Additional Comments
Submit