NEA Representative Assembly CEEH Discriminatory Incident Report Form

NEA Representative Assembly CEEH Discriminatory Incident Report Form

The NEA's Committee on Equity & Ethnic Harmony reviews discriminatory allegations involving NEA delegates and makes recommendations to the NEA President to expedite the resolution of such matters. Please complete the Discriminatory Incident Report Form to document any incident of discrimination you experience during the NEA Representative Assembly.

Submitter Details

First Name of Submitter*

Last Name of Submitter*

State Association*

Select or enter value

Local Association*

Cell Phone Number*

Phone

Email Address*

Details Regarding the Incident

Date of Incident*

Time of Incident*

Description of Incident*

Place Incident Occurred*

If this was posted, upload a copy of the post if available

Attach/upload sheets or other pertinent information here.

Drag and drop files here or

Name of Person(s) With Whom Incident Occurred (if known)*

Witness(es):

Signature*

Date of Signature and Submission*

Committee on Equity and Ethnic Harmony

Committee Members:

Gladys Marquez - Executive Committee Co-Chair, Illinois

Mark Jewell - Executive Committee Co-Chair, North Carolina

Chelsie Acosta, Utah

Tracy Hartman-Bradley - Nebraska

Jodi Kunimitsu - Hawaii

Karen Moore - Illinois

Alberto Nodal - California

Jamila Walton - Kansas

NEA Staff:

Rocio Inclan (she/her) - Sr. Director, NEA Center for Racial & Social Justice

Alexandria Richardson (she/her) - Manager for Business Affairs, NEA Center for Racial & Social Justice

Jason Walta (he/him) - Deputy General Counsel, Office of General Counsel

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