Hearthlight Public Incident Report
This is an official form for reporting incidents and problem individuals to Hearthlight officials. This report will be "anonymized" to protect the privacy of complainants, however all reports must be filed using your full legal and in-game names and a valid email address. This information will only be visible to the person(s) collecting these reports and will never be shared without your permission. You may choose to give permission for your name to be shared with the decision making body to whom this report will be forwarded, which may include, The National Council, The Board of Directors, Chapter Relations, or Local (Chapter) Leadership.

Email *
May we share your email address with Hearthlight officials with the intent of researching this incident? *
Your Name *
Your full legal name. Your name will only be shared with your permission.
May we share your name with Hearthlight Officials with the intent of researching this incident? *
Location/Chapter *
Where did the incident occur/to what chapter does the person involved in the incident belong?
Time frame of Incidents *
Please describe the time frame of the incidents the individual was involved with. For example "Over the course of the summer of 2017" "On July 4 2011" "Between 2001-2015" "[event] 2016"
Name of Person(s) involved in the incident *
Please describe the incident with the person(s) named above. *
Please check all that apply in regards to the incident: *
Please be as accurate as possible.
Did the incident occur at a Hearthlight Event? *
Was the incident reported to Chapter/Event officials? *
Were any criminal or civil charges filed? *
If charges were filed, was there a conviction?
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