KWC Bias Response Intake Submission Form

The KWC Bias Response Team acts as the college’s first response team in addressing reported bias incidents in which no respondent can be identified. All reported bias incidents will be referred to the Coordinator of Equity and Inclusion/TIX who will make an initial determination of whether the matter should be referred to the entire Bias Response Team for review.

Name

First Last

Email

Phone

I am a

KWC Student

KWC Faculty/Staff Member

Friend of the Panther Community

Details about the incident/time and location of incident

Please provide as much information as possible about the incident.

Who was involved in the alleged bias incident?

Please list the names of all the students/groups that were involved in the incident.

Please list any witnesses or other parties that were present during the time of the incident:

Please list any other descriptive information you may have related to the incident: