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BIC Incident Support & Reporting Form
Please use this form to report your concerns, document issues for later reference, or report individuals who are not following code of conduct.
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Email
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Your email
Name:
*
Your answer
Email:
*
Your answer
Contact Phone Number:
Your answer
Would you like us to follow up?
Yes
No
Maybe
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What happened?
Your answer
Incident
Misconduct (Person)
Misconduct (Organization)
Assault (Hitting/Touching)
Sexual Assault
Robbery
Lost Items
Misconduct (Speaker)
Misconduct (Conference Staff)
Harassment
Inappropriate Recording (Audio/Video/Other)
Other:
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When did the event occur?
MM
/
DD
/
YYYY
Where did the event occur?
Your answer
What affiliation does this person have? ( i,e: Where they apart of a certain group visiting our event? Did they have on a company t-shirt?)
Your answer
Who/How many people were involved?
Your answer
Describe the party who was acting inappropriately to the best of your ability:
Your answer
Questions, Comments, Concerns:
Your answer
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