Info + Resources Gear Get Involved FAQs Register Today
Report It!

Are you experiencing resistance to your Day of Silence organizing or activities from your school administrators or faculty? If you are a student in a U.S. K-12 school and feel like your rights are not being respected, please fill out this form to let us know! Not sure what your rights are? Please click here to read The Freedom to Speak (Or Not) from Lambda Legal.

PLEASE NOTE: Information is shared with GLSEN and Lambda Legal, and if you provide contact information, Lambda Legal may contact you to follow up.

What is the name of school?


City and state where school is located:


Is this a public or private school?

Your name:

Student   Parent   Faculty   GSA Advisor   Other:

Your email:


Your phone:
Cell   Work   Home  

What is your age/grade?


What is the best time to contact you?


What is the best way to contact you?
Email   Phone   Please do not contact me
If requested, we may contact you to ask for more information about your situation.

If you are a student, are your parents/guardians supportive of your Day of Silence participation?
Yes   No

Do you want to speak with someone about your rights?
Yes   No

Is your Day Of Silence sponsored by a club like a GSA?

Yes   No

If yes, what is the name of the club?


What is happening at the school?
Not allowed to use PA
Not allowed to put up posters
Not allowed to distribute materials
Not allowed to wear T-shirt
Required to speak during class
Required to wear school uniform/adhere to dress code rules
Other (please describe the situation)


How do you know?
I was directly affected
I heard it from others
I was told by a school official (please enter name of school official and title)


If you know or can find out, please tell us what the student handbook or school website says about the school policy on distributing information or hanging up posters?


Are you being prevented from doing activities that other students/groups have been allowed to do?Ex. Other clubs have handed out flyers for events, but we have been told we can't do it for Day of Silence.

Yes   No

If the answer is yes and your Day of Silence is NOT sponsored by a club, please describe the types of posters that you have seen other students hang up that were not school or club sponsoredor PA announcements that you have heard announced that were not school or club sponsored.


Have you or students in this school been threatened with some kind of disciplinary procedure?
Yes   No

If so, what?


Are you or students in this school currently facing discipline for participating in a DOS activity?
Yes   No

If so, what?


Have you or students in this school been told that they will be suspended or have been suspended for their speech activities?
Yes   No

Is there anything else you want to tell us?


Do you want a legal organization to send an anonymous letter to the school outlining what you have told us is happening and the school's obligations under the law?
Yes   No   Contact Me First
Please be aware that although an advocacy letter would not mention your name, you could be indirectly indentified as the source for the information based on your efforts to participate in DOS.

FacebookTwitterYouTubeBlog
Why be silent?
 
Facebook Share Images
Copyright 2014 GLSEN, Inc., the Gay, Lesbian & Straight Education Network. All rights reserved.
GLSEN  
Championing LGBT Issues in K-12 Education since 1990
90 Broad Street, 2nd Floor
New York, NY 10004
Phone: 212-727-0135
Fax: 212-727-0254
www.glsen.org
Check out all of our programs:
Safe Space Kit
ThinkB4YouSpeak
Gay-Straight Alliances
Ally Week
No-Name Calling Week
Changing the Game