Report Now: Reporting on Behalf of Someone Else

Incident Classification

Hate Crime Hate-Motivated Crime Hate Incident Online Hate Discrimination Other (please specify)

* Date of Incident If you don't remember the exact date, please provide the closest approximate date.

Ethnicity

Black East or South-East Asian South Asian Arab or West Asian Indigenous White Other Race or Ethnicity Race or Ethnicity Not Specified

Other support If you answered "Other" above, please specify.

Notes Last updated notes should be at the top

Case Status Open Closed

* City / Municipality

Other City / Municipality If you answered "Other" above, please specify.

If possible, please provide an address or nearby landmark where the incident occurred

Other If you answered "Other" above, please specify the place.

* What happened during the incident? Verbal Hate / Harassment (Name Calling / Offensive Jokes, Racial Slurs / etc.) Threats of Violence Physical Assault (Including with a Weapon / Spitting / Pulling Off Hijab/Turban) Vandalism (Graffiti / Destruction / Theft / Damage / Harm to Property or Personal Belongings / Trespassing) Publicly inciting genocide or violence against a group Other

Other incident If you answered "Other" above, please specify.

Other reason If you answered "Other" above, please specify.

Tell us what happened in as much detail as possible You can attach evidence below

Evidence Please attach any relevant photos, video, or documents that may be relevant to the incident.

Supported file types: Word, PDF, GIF, JPG, PNG, HEIC, WEBP, MP4, M4V, AVI, MOV

If evidence files exceeds 10MB, please email [email protected] to arrange for further support.

What is the victim's gender? Male / Male-Identified Female / Female-Identified Non-Binary Prefer Not to Say Doesn't Apply (Group or Community was Targeted)

Other ethnicity If you answered "Other" above, please specify.

Other religious / faith background If you answered "Other" above, please specifiy.

Was the victim wearing any cultural / religious clothing when the incident took place? No Cross Hijab / Head Covering Kippa Turban Other

Other clothing If you answered "Other" above, please specify.

* Do you want help from CMW? Yes No

Personal Information

These fields are optional if you do not require help. If you wish, you can submit the report anonymously.

Have you reported it to the police? Yes No

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I am a Reporting on Behalf of the Victim