National DSA Grievance Report
This is the confidential national grievance reporting form for DSA’s Harassment Policy. It complies with Resolution #33, passed at the DSA Convention of 2017. By filling this out, your report will be officially filed and the National Grievance Officer (NGO) will reach out to you. At this time, our process is confidential but not fully operational, so it will take longer than a week for us to reply. Once the process is fully operational, the timeline for a response will be one week or less. The actual determination of your grievance report will likely take much longer, and filing does not guarantee that national will make any particular findings or carry out remedies or penalties. You will receive notice of the disposition of your grievance.

Please note that at this time, grievances filed with this form will be held in abeyance until we have hired a national grievance officer this spring.

To learn more about Resolution #33, please read here: https://docs.google.com/document/d/14PXU8_0eKmPG_8GSVVyHurorNcNPOQN_mq-mAdCOUao/edit

Have you filed this grievance at your chapter? *
If you filed at your chapter level, please explain why you are also filing on a national level. Also, please provide any contact information for a chapter leader or grievance officer that we can follow up with. *
Your answer
Reporting Member Name *
Please fill out your name. Please note: you can choose between providing an email, phone, or both. If you provide neither, your claim will be not processed.
Your answer
Reporting Member Email Address
Your answer
Reporting Member Phone Number
Your answer
Your Chapter
If applicable, please list your DSA or YDSA chapter.
Your answer
Click Here if Filing a Collective Grievance
If this is Grievance is on behalf of two or more individuals, please click yes.
Collective Grievance: Reporting Members
Please provide names and contacts for other reporting members if part of a collective grievance.
Your answer
Reported Member's Name *
Whose actions are you reporting?
Your answer
Description of the Incident *
Please provide a detailed description of why you believe there has been a violation of DSA’s Harassment Policy, including the date(s) and location of the behavior you're reporting, a description of the incident(s), the names of individuals who may have information about the incident other than those filing the grievance, whether there is any relevant documentation, what resolution are you are seeking, and any other details you would like to provide to the NGO.
Your answer
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