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Racial harassment report form

This is a form that can be used by an individual to report incidents of racial harassment.

2 minutes to complete

Eligibility

Anyone who has experienced racial discrimination can use the racial harassment report form to file a complaint.

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Questions for Racial harassment report form

Questions

1.

What is your name?

The answer should be a text input.
2.

What is your position at the university?

The answer should be a text input.
3.

What is the nature of the incident?

The answer should be a text input.
4.

When did the incident occur?

The answer should be a date input.
5.

Where did the incident occur?

The answer should be a text input.
6.

Who was involved in the incident?

The answer should be a text input.
7.

What was said or done during the incident?

The answer should be a text input.
8.

Were there any witnesses to the incident?

The answer should be a single choice:
  1. Yes
  2. No
9.

What was the outcome of the incident?

The answer should be a text input.
10.

Would you like to take any further action?

The answer should be a single choice:
  1. Yes
  2. No

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Here are some FAQs and additional information
on
Racial harassment report form

How do I report racial harassment?

There are a number of ways you can report racial harassment. You can contact your local police department, or submit a racial harassment report form to your school/college administration.

What information do I need to include in my report?

When you file a report, be sure to include as much detail as possible. Include the date, time, and location of the incident, as well as a description of what occurred. If you have any witnesses, be sure to include their contact information as well.

What happens after I file a report?

After you file a report, an investigation will be launched. The investigation will aim to determine whether or not the incident was motivated by race. If it is determined that the incident was motivated by race, the individual responsible may be subject to criminal charges.

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