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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.

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 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

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
Not allowed to have activity or event on school grounds
Other (please describe the situation)


Are you being prevented from doing activities that other clubs/individuals been allowed to do?
Yes   No

Ex. Other clubs have handed out flyers for events, but we have been told we can't do it for Day of Silence.

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?


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