Lone Star District Qualifier

for the 2021 National Tournament

Equity Form

Lone Star NSDA Equity Office Intake Form

INSTRUCTIONS: Any tournament attendee who believes that they have been harassed or

discriminated against may complete this form to report the alleged violation. After a

complainant submits this form, the Equity Committee may contact the individual

complainant and conduct a discussion concerning the grievance(s) in the form, through

Zoom or a similar platform. After the discussion, the Equity Committee will investigate the

allegations in the form, including speaking to parties involved and impacted. After the

investigation is complete, the Equity Committee will make a referral to the Tournament

Directors about the findings and recommended course(s) of action. All parties impacted

will be notified of this decision upon its completion. While we do ask for name and contact

information, those questions are * totally optional * and you can exclude that information if

there is something you would like to anonymously report. That said, if you would like our

Equity Office to follow up with you as part of the investigation, we need you to please

include your full contact information. Equity Committee members will keep the information

disclosed as confidential as possible. Please be aware: ethically, Equity Committee

members are required to take appropriate action and notify authorities if students engage

in behavior that presents clear and imminent danger to themselves or others, in the case

of known or suspected child abuse or neglect, or in the case of known or suspected

sexual violence. All members of the Equity Committee are mandated reporters.

Lone Star NSDA Equity Office Intake Form

1. Your Name: (optional)

2. Your Email: (optional)

3. Your Phone Number:

4. Your School:

5. Are you a:

____ Student ____ Judge ____ Coach ____ Other

6. If you are a competitor, what is the name of your coach or adult present at the

tournament?

7. If you are a competitor, what is the phone number of your coach or adult present at the

tournament?

8. In which division, round and in what event did this incident occur?

9. Please describe the incident/your area of concern.

10. Please explain your requested remedy (i.e., what would you ideally like to see us do

to resolve the above concern/incident?)

Please email this completed form to Kristy Thomas (kristy@alwayswriting4u.com