INW Conduct Committee Incident Report Form

Ignition Northwest Incident Report Form

Use this form to report incidents you witnessed or experienced that violate INW's Code of Conduct and/or our community's principles. INW's Code of Conduct is available here: https://ignitionnw.org/inw-code-of-conduct/
What happens after I submit this report?

Reports submitted via this form go directly to a secure file accessible only to members of the INW Conduct Committee. A Conduct Committee member will reach out to you to acknowledge your report (unless you request no follow-up or anonymity). The Conduct Committee will then review your report. If you request follow-up, a member of the Conduct Committee will reach out to you.
Your Name (Reporter)

First NameLast Name
Other name(s) you use (Reporter)
Do you want to remain anonymous?
Do you want follow-up from the INW Conduct Committee and/or to be included further in this process?

Other
How would you like the INW Conduct Committee to contact you?

Other
Contact Email
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Do you need support? Do you want the INW Conduct Committee to reach out about counseling and other resources available to community members?

Other
Did this incident happen to you?
What kind of incident are you reporting?

Other
Who are you reporting?
If you don't know a name, please include any details you know (e.g. "Tall, thin, white male with long, straight, dark hair and a tattoo on his shoulder. He was selling ice on Tuesday afternoon.)
Did this happen at an event? If so, which one(s)?

Other
Approximate date/time/location of the incident
Names of any bystanders (if any)
Narrative explanation of the incident (in as much detail as you are able to remember)
If you have a resolution in mind, please describe
It is okay if you don't have one at this time, or if it changes over time
Is there any other information or background context you feel the INW Conduct Committee should know in order to understand in this incident?
Attach files if needed

Cancelof
The INW Conduct Committee will not pursue legal action. However, if you or someone else pursues legal action regarding this incident, it is possible that communication with the INW Conduct Committee (including this report) could be subpoenaed under certain circumstances
Should be Empty:

Ignition Northwest Incident Report Form

What happens after I submit this report?