Zeta Tau Alpha Fraternity

Test Form

1. Name of Individual Reporting Concern

First Name

Last Name

2. Relationship to Zeta Tau Alpha

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 ConcernPolicy Violation

7. Please describe the incident in detail and include specific date, times and locations.