FPCS Incident Report Form
To file a report with the FirePony Creative Society Conduct Committee, please fill out and submit this Incident Form. This form collects information regarding possible Code of Conduct violations. The completed form should contain sufficient detail for the investigators to begin an investigation. Conduct Committee Leads receive this form first, and then they will review the report with you before assigning your case to a team investigators.
Sign in to Google to save your progress. Learn more
Reporter's (Your) Name
Report anonymously *only* if you do not wish to have any follow up. Anonymous information can be useful when it contains verifiable facts or helps build a pattern of behavior but information with no contact information is, by its nature, is of limited value in our process.
If you wish to be contacted for follow up, enter your email address.
What is the nature of the violation that you wish to report? *
Please check all that apply.
Required
Name of the person(s) you are reporting? *
Please note the date and time (if possible) when the incident took place. *
If there were several instances, please enter a time range and call out any specific instances in the narrative.
Where did the incident or incidents take place? Please be as specific as possible. *
Name all persons involved in the incident, if possible.
Were bystanders present when the incident(s) occurred?
If yes, please specify if you are acquainted with them should the investigators need to reach out to them with your approval.
Basis of Complaint *
Please describe the incident(s)
How does the reported conduct impact the FirePony community and FirePony events (PDF and Constellation)? *
Please note: if this form is received during hiatus, it will be received by the Conduct Committee after they reconvene. If you shared an email address in this form, you will receive an email from the leads once Conduct Committee resumes and processes your submission. *
The Conduct Committee will not pursue legal action, however if you were to do so on your own, all recorded communication received by the Conduct Committee (starting with this report) can be subpoenaed under certain circumstances
Please review relevant state laws in this living document https://docs.google.com/document/d/1aDc4SGVbWk7lMVHECKfFznzapvPVboyQ66QRgdEPFzU/pub
Clear selection
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of FirePony Creative Society.

Does this form look suspicious? Report

Google Forms