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Incident intake form

The Muslim Parent Association is committed to finding the resources to support our students and families. In order for us to better advocate for our families and to pull resources, we are asking you to share your experiences. We want to be able to track any incidents of harm or harassment, verbal or non-verbal, your family has witnessed and/or experienced. We encourage folks to fill out this intake form to document any incidents of harassment/hate. We also welcome any feedback regarding actions you’ve taken to report/address these concerns. 

What grades are your child(ren) in?
What District(s) are your child(ren) in?
Based on the above, do you feel safe?
Did you report the incident?
If you reported the incident above, have they responded?

Thanks for submitting!

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