Incident Report Form

Please use this form to report any instance where you feel you have faced or witnessed harassment, discrimination, unfair treatment, or some other violation of the Member, Captain, or Officer Code of Conduct.
Complainant Information

Please provide us with information about yourself so that we may follow up with you about your report.
Conference/Team*
Submitter*

First NameLast Name
Submitter's Email Address*
example@example.com
Preferred Pronouns

Complainant Information