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Test Form
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1. Name of Individual Reporting Concern
First Name
Last Name
2. Relationship to Zeta Tau Alpha
Current Member
New Member
Alumna/Volunteer
Peer/Student/Roommate/Friend
Parent/Guardian
Community Member
Institution Faculty/Staff
Other
Name of ZTA Chapter or University
Example: Alpha Alpha Chapter or Imaginary University
3. Email
4. Phone Number
5. Name(s) of ZTA member(s)/new member(s) involved
6. Nature of Report
Bias Incident (any discriminatory or hurtful act that appears to be motivated by identity)
Health, Safety and Well-Being Concern
Policy Violation
7. Please describe the incident in detail and include specific date, times and locations.
Submit