WIT Sexual Misconduct Reporting Form
Thank you for reaching out to share your concerns or information regarding sexual misconduct at Washington Improv Theater. We are committed to creating a culture at WIT that is safe and joyous for everyone, so we take this issue very seriously.

ANONYMITY: If you wish to remain anonymous, skip the questions about your identity and contact information. Note that this will make it impossible for us to follow up with you, so please try to give information that is as thorough and detailed as possible. If you wish for the complaint to remain confidential, you may indicate that. That means we may contact you for verification or further info, but we will not name you to the person you are reporting unless you say we may.

This report will be initially read by WIT artistic & executive director Mark Chalfant and shared with appropriate staff or board personnel as necessary. If you need to report conduct by Mark Chalfant, please contact WIT board chair Goli Samimi at gsamimi@yahoo.com .
Please keep this report *
Required
What do you wish wish to report? *
Please be as detailed as possible. Who were the parties involved? What behavior did you witness, or hear about? Where did it take place? When did it occur? Was the behavior called out? Were there any consequences or follow-up afterword?
Your answer
Location where the incident or behavior took place
Date/s when the incident or behavior took place
Your answer
Other witnesses?
Was anyone else present to witness the incident or behavior? If so can you tell us who?
Your answer
Your name (if you are comfortable providing it)
Leave blank if you wish to remain anonymous
Your answer
Your email (if you are comfortable providing it)
Leave blank if you wish to remain anonymous
Your answer
Your phone (if you are comfortable providing it)
Leave blank if you wish to remain anonymous
Your answer
Contacting you: If this is NOT an anonymous submission, someone will be reaching out to you to acknowledge receipt of this and possibly to ask follow-up questions. Do you have a preference regarding who should reach out?
Select one or more than one.
Submit
Never submit passwords through Google Forms.
This form was created inside of Washington Improv Theater. Report Abuse