Kiez Burn Harm Reporting
This form collects information regarding possible Code of Conduct violations. To file a report with the the Kiez Burn Radical Accountability Division (RAD), please fill out and submit this form. The completed form should contain sufficient detail for the investigators to begin an investigation. If the report warrants an investigation, RAD will assigning your case to a team of two investigators who you will have a chance to approve of.

All information shared in this form will be treated confidentially and is accessed only by the RAD members. You can find a list of RAD members and more information about the RAD's work on Kiez Burn website: https://mmm.kiezburn.org/rad . If you have a strong reason for withholding information from a particular RAD member you can leave a contact request to our email rad@kiezburn.org. Please mention who you would like to contact you. 

RAD @ Kiez Burn Wiki
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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 but information with no contact information is, by its nature, of limited value in our process.
What are your pronouns 
What is your email address?
If you wish to be contacted by the RAD team please provide us your email address. We will use your email only to contact you about the case you are reporting. 
What is the nature of harm / violation that you wish to report? *
Name of the person(s) you are reporting? (or physical details helping to identify) *
Include or indicate any alias. You can also give us any physical detail, you would remember if you don't know the name of the person. However it is ok if you do not remember anything, this is part of the injury you go through, nothing you should blame yourself for, right ?
How is the person connected to the Kiez Burn Community?
For example, has the person attended Kiez Burn festival or other KB up events and/or related burner events, or other burn events inside or outside the local community?
Please note the date and time, if possible, when the incident took place. *
If you're reporting several instances, please enter a time range and note any specific instances in the narrative.
Where did the incident or incidents take place? *
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. Include email addresses if possible and appropriate. We will not contact anyone without discussing the case with you first.
Basis of Complaint
Please describe the incident(s)
The Conflict Awareness team seeks your intention for filing this report.
Confidentiality *
All information shared in this form will be treated confidentially and is accessed only by the Kiez Burn Radical Accountability Division (RAD) members. You can find a list of RAD members and more information about the RAD's work on Talk https://talk.kiezburn.org/g/3czR8BKr/members. If you have a strong reason for withholding information from a particular RAD member please do not use this form, but contact any of the RAD members personally (contact information for each member is available on Talk)
Required
GDPR Disclaimer: *
I consent to my data being stored for a period of up to 36 months from the last date my data was entered or modified, and for it to be used only to facilitate the scheduling and safety of volunteers on behalf of Kiez Burn. I understand that you will delete my data within one month of my giving formal written notice to the registered address of Kiez Burn, asking you to do so.
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