Mediation support Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form.Are you a witness or victim? *victimwitnessWhat is the nature of the facts? *DiscriminationVerbal agressionPhysical agressionMoral harassmentSexual agressionSexual harassmentRapeOther ** if Other, can you be more precise, please:If you wish to give us more detials:Where did it happen:At the bar/common-room, in the toilets, a corridor, screening-room...Date and time of the act: *(at least approximatively)Do you wish a memeber of the collectif to contact you?If Yes, you can mention a contact where you're available, or give an appointment in a public place to meet one of us.Do you wand to be noticed in case we receive more testimonies in relation with the mentioned act?You can also give us the contact details of a lawyer or a different person, and please mention his/her fonction, if necessary.Send
