School Enrollment Bias Report Form
Please use this form to report any concerns or incidents of bias related to the school enrollment process. Your report will help us ensure fairness and address issues appropriately.
Your Full Name
*
First Name
Last Name
Your Email Address
*
example@example.com
Relationship to Student/Applicant
*
Please Select
Student/Applicant
Parent/Guardian
Relative
School Staff
Community Member
Other
Student/Applicant Grade or Age Group
*
Please Select
Preschool
Kindergarten
Elementary (Grades 1-5)
Middle School (Grades 6-8)
High School (Grades 9-12)
Adult Education
Other
School or Campus Name
*
Enrollment Stage or Process Involved
*
Please Select
Application Submission
Interview
Testing/Assessment
Documentation
Review/Decision
Enrollment Confirmation
Other
Date and Time of Incident
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Hour Minutes
AM
PM
AM/PM Option
What Happened? (Describe the Incident)
*
Bias Category
*
Race/Ethnicity
Gender
Disability
Language
Religion
Socioeconomic Status
Other
Who Was Involved? (If Known)
Additional Details or Evidence (Optional)
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