BPS Bias Incident Report Form

I want to report an incident of racism or bias which I have experienced or witnessed which involves a member of the Belmont Public Schools, including staff, volunteers, or students.

  • 1
    Step 1
  • 2
    Step 2
  • 3
    Step 3
  • 4
    Step 4
School Primarily Involved
PLEASE NOTE: The Principal of the school you select and the DEI Director will both receive a copy of your online report. If you do not want a principal to see your report, please select "Other" and the report will go only to the DEI Director.
  • *
Your Information
  • *



Contact Information
  • *




Incident Information
  • *
  • *
  • *
  • *
  • *
  • *













  • *
  • *
  • Your browser doesn't have Flash, Silverlight or HTML5 support.