MGHA Conduct Reporting Form The purpose of this form is to confidentially report a violation or possible conduct in accordance with the Madison Gay Hockey Association Code of Conduct. The form will go directly to the Board Member in charge of Conduct review (Maggie Augustin). If the incident involves the Board Member in charge of Conduct directly, the form will go to a different Board Member. Once reported, the following options are available: 1. It gets filed as an informational report and no further action is required at that time. 2. A committee will be assembled using folks who are not directly related to the incident or close to the individuals involved in the incident to review the form and come up with an appropriate course of action. You will be contacted for further follow up within a week including how you would like this information handled. Your Name*How would you like your form handled?*Strictly informational to be filed for future reference.Request that a committee be assembled for review of the form and incident.Unsure of how to proceed and would like a recommendation from the Board.Best way to contact you for follow-up?*Date of incident* Name(s) of the person(s) involved in the incident:Describe the incident using specific and objective language (who, what, where, when, and how it happened):*How did this violate our Code of Conduct?*Code of ConductPlease describe, in your own words, how this impacts you, your team, and/or the league:*Additional comments or thoughts?NameThis field is for validation purposes and should be left unchanged.