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Misconduct Report Form
Nueces Mosque and Texas MSA strive to make our community spaces a safe and supportive environment.

If you have been affected by any form of misconduct by a community member and would like to inform MSA and/or Nueces, please fill out the form below so the Nueces and MSA Leadership Teams can assist in connecting you to the proper resources. The form responses will be monitored by the respective leaders of the Nueces and MSA ECs.

Please note that Nueces and MSA do not provide legal or investigative services and we encourage you to connect with the appropriate community resources if you're needing legal support (SAFE ALLIANCE: safeaustin.org/our-services/face-to-face-support/legal-services/ AND UT TITLE IX: titleix.utexas.edu/file-a-report).

You may choose to fill out the form anonymously. If you choose to do so, it is HIGHLY RECOMMENDED you leave a trusted friend's contact information to act as a medium of communication. This will also allow the EC to have a form of contact following your report to discuss any next steps. Nueces and MSA will attempt to provide support only within our scope as community organizations.

More information on the Nueces/MSA's Zero Tolerance Policy and Action Plan regarding misconduct can be found:
https://docs.google.com/document/d/14tIdz5yTGkPsa64gLB8EqPClld1NFbdp2-Wu8Oxj6vY/edit?usp=sharing

Nueces and MSA reserve the right to close or modify this form to best fit the needs of our community members.
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Optional: Name
If you are filling this out for a friend/acquaintance please skip to friend's contact info
Optional: Phone Number
Optional: Email Address
The following includes questions regarding including a friend/acquaintance's contact information if you feel uncomfortable sharing your own information to remain anonymous. This information is not required but is HIGHLY RECOMMENDED if you would like the Texas MSA and Nueces ECs to take any action or follow up.
Highly Recommended: Friend's Name
Highly Recommended: Friend's Phone Number
Highly Recommended: Friend's Email Address
Complaint: *
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