Jagged Little Pill Incident Reporting Form

This form may be used to report incidents of bias, bullying, discrimination, and/or harassment involving Jagged Little Pill (JLP) cast, crew, and/or employees. Please complete one form per incident. JLP takes incident reports very seriously and every effort will be made to evaluate your report promptly.

Please note, the extent to which JLP addresses the incident report will depend upon the information provided, the swiftness with which the incident is reported, and whether or not you wish to remain anonymous. Please provide as many details as possible; the information contained in the report will be shared with The Office of People & Culture who will facilitate subsequent incident monitoring, investigation, and/or resolution finding. Your contact information and confidentiality will be maintained to the greatest extent possible.

This form has NOT been designed to inform or explain any laws as they pertain to your legal rights, and should not be used for that purpose. Instead, it should be used exclusively to report incidents you believe violate JLP Anti-Discrimination, Anti-Harassment, and Anti-Racism policies.

THIS IS A REPORTING TOOL FOR NON-EMERGENCY INCIDENTS ONLY. FOR EMERGENCIES, PLEASE CALL YOUR LOCAL POLICE DEPARTMENT.

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* 1. Date and Time of Incident:

Date / Time

Date

Time

AM/PM

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* 2. Have you previously reported this event?

Yes (Please specify the person to whom you reported and when you first reported the incident.)

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* 3. Please select one of the following:

I experienced bias, discrimination, hate, harassment, sexual harassment, and/or bullying.

I witnessed bias, discrimination, hate, harassment, sexual harassment and/or bullying.

I may have been the perpetrator of biased, discriminatory, hateful, harassing, sexually harassing and/or bullying behavior.

I have been accused of being the perpetrator of bias, discrimination, hate, harassment, sexually harassing and/or bullying.

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* 4. Please select one of the following:

The incident occurred on JLP company grounds or physical space.

The incident occurred off JLP company grounds or physical space.

The incident occurred in a JLP virtual space.

The incident occurred in a non-JLP virtual space.

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* 5. Please select with which of the following you are affiliated:

Jagged Little Pill Tour

Other (please specify)

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* 6. Please describe the setting where the incident took place:

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* 7. Please select the nature of the incident: (Select all that apply.)

Bias: is a preconceived negative opinion or attitude in favor of or against one thing, person, or group of people who possess common physical characteristics or cultural experiences compared with another, usually in a way considered to be unfair.

Bullying: an ongoing and deliberate misuse of power in relationships through repeated verbal, physical and/or social behavior(s) that intend to cause physical, social and/or psychological harm involving an individual or group misusing their real or perceived power over one or more persons who feel unable to prevent it from happening.

Discrimination: is the prejudicial treatment of others or the act of treating others differently and unfavorably based on prejudicial or unjustified distinctions in policies, laws, or treatment, usually based on race, ethnicity, nationality, class, caste, religion, belief, sex, gender, language, sexual orientation, gender identity, sex characteristics, age, health or other statuses.

Harassment: includes verbal, visual or physical conduct that denigrates or shows hostility or aversion to an individual because of any protected characteristic when such conduct has the purpose or effect of unreasonably interfering with an individual or third party’s work performance; creating an intimidating, hostile, or offensive work environment; or otherwise adversely affecting an individual or third party’s employment opportunities. Harassment may include but is not limited to: verbal abuse or ridicule, including slurs, epithets, and stereotyping; offensive jokes and comments; threatening, intimidating, or hostile acts, and displaying or distributing offensive materials, writings, graffiti, or pictures. Harassment may include conduct carried out through the internet, email, social media, or other electronic means. Protected categories include age, color, disability, family responsibilities, gender identity and expression, genetic information, marital status, national origin and accent, personal appearance, political affiliation, pregnancy, race, religion, sex, sexual orientation, source of income, veteran’s status, or other factors prohibited by law.

Hate Crime: incidents that are motivated by bias against one’s actual or perceived race, color, religion, national origin, sex, sexual orientation, gender, gender identity or expression, ability, age, marital status, personal appearance, homelessness, or political affiliation of a victim of the subject designated act.

Hate Incidents: acts of prejudice against a protected class that are not criminal and do not involve violence, threats, or property damage.

Hate Speech: public speech that expresses hate or encourages violence towards a person or group based on an aspect of identities, such as race, religion, sex, or sexual orientation; an expression that falsely defames a specific individual or constitutes a genuine threat, or unjustifiably invades substantial privacy or confidentiality interests.

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* 8. Please identify any possible factors related to this incident: (Select all that apply.)

Ability/Disability

Age

Ancestry/National Origin

Gender Identity or Gender Expression

Language or Language Expression

Race or Ethnicity

Physical Presentation

Religion

Sex/Gender

Sexual Orientation

Other (please specify)

None of the above

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* 9. Please identify other possible witnesses to the incident, if applicable:

Cast Member(s)

Contractor(s)

Employee(s)

Patron(s)

Management

Crew

Other (please specify)

None of the above

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* 10. Please describe the incident, providing as much detail as possible:

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* 11. Would you like for JLP to respond to the incident?

Yes

I need more information to make a determination.

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* 12. As JLP reviews your report and determines the most appropriate response, your suggestions are welcomed. If you have any recommended responses, please detail them below.

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* 13. You may provide your name and request that it be held in confidence as the inquiry goes forward. If you request that your identity remain confidential, persons handling the inquiry will do so to the extent practicable and permitted by JLP policies and applicable laws. JLP's ability to investigate allegations of misconduct and to take corrective action may be impeded if your identity is not provided to the person responding to the complaint. Depending on the nature of the allegations(s) raised (e.g. unlawful discrimination or sexual violence), conducting a fair and complete investigation may require that the full details of the incident, including your identity, be shared. In those instances, all parties will be advised of JLP policy against retaliation for making complaints.

If you wish to remain anonymous, please ensure that the auto-fill option is disabled on your web browser. Please close your browser after you have submitted the form. Note: In incidents of alledged sexual harassment, names must be provided according to the law. In addition to, or instead of completing this form, you may contact The Office of People & Culture for guidance and support at 510.565.0925.

Yes

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* 14. Contact Information: (Complete only if you do not wish to remain anonymous.) In incidents of alledged sexual harassment, names must be provided according to the law.

Name

Email Address

Phone Number

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* 15. Your affiliation with JLP:

Cast Member

Contractor

Employee

Crew

Management

Other (please specify)

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* 16. Thank you for completing the JLP Incident Reporting Form. The Office of People & Culture will contact you via phone or email regarding your submission within 2 business days.

If you have documents related to this incident, you may upload them here.

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Choose File

Jagged Little Pill Incident Reporting Form

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* 1. Date and Time of Incident:

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* 2. Have you previously reported this event?

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* 3. Please select one of the following:

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* 4. Please select one of the following:

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* 5. Please select with which of the following you are affiliated:

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* 6. Please describe the setting where the incident took place:

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* 7. Please select the nature of the incident: (Select all that apply.)

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* 8. Please identify any possible factors related to this incident: (Select all that apply.)

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* 9. Please identify other possible witnesses to the incident, if applicable:

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* 10. Please describe the incident, providing as much detail as possible:

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* 11. Would you like for JLP to respond to the incident?

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* 12. As JLP reviews your report and determines the most appropriate response, your suggestions are welcomed. If you have any recommended responses, please detail them below.

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* 14. Contact Information: (Complete only if you do not wish to remain anonymous.) In incidents of alledged sexual harassment, names must be provided according to the law.

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* 15. Your affiliation with JLP:

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* 16. Thank you for completing the JLP Incident Reporting Form. The Office of People & Culture will contact you via phone or email regarding your submission within 2 business days.If you have documents related to this incident, you may upload them here.

* 16. Thank you for completing the JLP Incident Reporting Form. The Office of People & Culture will contact you via phone or email regarding your submission within 2 business days.

If you have documents related to this incident, you may upload them here.