Bias Report Form

Campus Safety Notice

Complainant Information
Entering personal contact information is completely optional. We invite you to submit this form anonymously, however if you would like to be contacted regarding your submission be sure to include the necessary contact information.
Incident Information
Date of Incident *
Approximate Time of Incident *
:
Choose AM or PM:
What bias do you feel was the target of the incident? Please select all categories that apply.
Please include all pertinent facts, behaviors, comments, gestures, markings, clothing, or distinguishing characteristics.
Optional

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