RDU Blues Safer Spaces Report Form
If you would like to remain anonymous, do not fill in the contact information below. Your email will not be associated with your response unless you fill in the email option below. If you are looking for a response or further action to be taken, please provide contact information.

Other options for reporting are speaking to any organizer, using the physical feedback box present at dances, or emailing us at rdubluessafety@gmail.com

Only current members of the safer spaces team can view the results of this form. Current members of the safer spaces team are Suzanne Julian, Amanda Marron, Katie Gaddis, Justis Peters, and Caroline Leitschuh.

Name (first and last)
Your answer
Email Address
Your answer
Incident Report
Your answer
When did this happen?
Your answer
Would you like a response from the safer spaces team? What kind of support do you need? (please make sure to provide your contact information)
Your answer
Do you want action taken? If yes, what sort of outcome are you hoping for?
Your answer
Is there anything else you want to share with us regarding this incident?
Your answer
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