Code of Conduct report (confidential)

What type of violation are you reporting?

Select all that apply

Sexual harassment (unwelcome attention and/or inappropriate contact)
Discrimination (acts of racism or homophobia)
Invasion of privacy (intrusive and/or unwanted behavior)
Violence or threatening behavior
Disruptive or drunken behavior
Other

If Other, please explain.*

How were you involved in the incident?*

What happened?*

Please share with us the what, when, and where.

Please identify the person(s) involved in the incident.

Your name will not be shared with the person involved in the incident, but TED needs to know who was involved in order to conduct a thorough investigation.

What is your preferred outcome?

Please note that in all cases, TED will discreetly follow-up on all reports to determine the appropriate course of action including: investigating the incident, warning/barring an attendee from an activity and/or the entire conference.

Is there anything else that you'd like to share?

How can TED follow up with you?*

If Other, please explain.*

Name

Phone Number*

Email*

Please provide a way that TED can contact you*

Ex. phone or email

Comments

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Code of Conduct report (confidential)

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