TJHS Discrimination/Harassment Form
Please complete this form if you feel that you have been a victim of bullying, discrimination, or harrassment for any of the following reasons: age, ancestry, color, ethnicity, gender, gender identity, gender expression, mental/physical disability, national origin, race, religion, sex, sexual harassment, seuxal orientation, or association with any of these categories.

If you would like to remain anonymous, please use Safe2Say: https://www.safe2saypa.org/tip/
Email *
Your name: *
Today's date: *
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You are completing this form on behalf of: *
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Please describe the type of harassment or discrimination that you experienced, including the events or actions, in as much detail as possible: *
List the people involved in harassing or discriminating against you: *
List any witnesses of the incident: *
Describe the location where the harassment/discrimination occurred: *
Please list the date(s) and time(s) when the harassment/discrimination occurred or when it first came to your attention: *
A copy of your responses will be emailed to the address you provided.
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