Ally Skills NZ Incident Report Form
Ally Skills NZ is dedicated to providing a safe, inclusive, and harassment-free experience for all participants, regardless of gender, gender identity and expression, sexual orientation, race, age, ethnicity, disability, physical appearance, body size, and/or religion. We do not tolerate harassment of participants in any form. Anyone who violates our code of conduct may be sanctioned or expelled from Ally Skills NZ spaces at the discretion of the Ally Skills NZ team.
Full policy:

**What happens when I submit this form?**

This form allows you to submit a digital report, anonymously if you would prefer.

If you choose to give identifying information, we may talk to you to find out more information. We’ll make sure this is discreet, and you can bring support with you. We will NOT force you to have any form of confrontation or discussion with any of the people involved.

Ally Skills NZ incident response team:
Lauren Peate, Erica Austin, and Vivian Chandra

Other resources:
Police / Emergency services: 111
Healthline: 0800 611 116 (support from registered nurses)
Rape Crisis: 0800 88 33 00 (support after rape or sexual assault)
Mental health helpline: 1737 (support from trained mental health professionals)

This form is based on the incident report form used by WWGSD:

What happened? *
Your answer
Where did this occur? (optional)
Your answer
When did this occur (approximately)? (optional)
Your answer
Were any other people involved or present? (optional)
Your answer
What can the organising team do to help you feel safer in our community? (optional)
Your answer
Is there anything else we need to know? (optional)
Your answer
If you would like us to follow up with you, please leave your name and contact details (email, phone, etc). (optional)
Your answer
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