Incident Report Form

This form is to report violations of the BIRS Code of Conduct. Form submisssions will be sent directly to the BIRS Scientific Director and Deputy Director.

Location

Please tell us the BIRS location where the incident occurred:



If applicable, please select the event during which the incident took place:

Contact Information (Optional)

If you wish to be contacted in a follow-up to your report, please provide your information so that we can do that. Otherwise, you may submit the report anonymously, if you prefer.

Do you wish to remain anonymous for this report?

Yes
No

Your contact details:






Incident Description

Please describe the incident, in as much detail as possible.

Mandatory Simple Test to Help Prevent Spam:

The product of 9 and 7 is: