Report an Incident

We take complaints of racial bias very seriously and are committed to addressing them quickly and thoroughly. Please fill out the form below to report any incident of bias or racial profiling and harassment in our stores.

Bias, Harassment, or Racial Profiling Form

Report an incident of bias, harassment or racial profiling in our stores.

Person Filing Complaint

Today's Date

Name

First Last

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone

Co-op Member

Yes

Incident in Question

Date of Incident

Time of Incident

Location of Incident

Bakery Café – Holly Street

Downtown Store – Forest Street

Cordata Store – Westerly Road

Name of Staff Member Involved

If name is unknown, can you describe the staff person?

Description of the Incident

Please write a description of the incident. Please be as specific as possible as to why you believe you were subjected to bias or racial profiling and harassment.

What actions would you like the Co-op to take to resolve this issue:

This field is for validation purposes and should be left unchanged.