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Hate- or Bias-Motivated Incident Report Form

Incident Information

Please indicate the type of incident (check all that apply):


Please indicate the category of bias (check all that apply):


Incident Details
Action You Are Requesting
Alleged Offender Information (if known)
Document Upload

Upload documents or evidence related to the incident here. (Limit 10, must be .pdf, .doc., .docx, .jpg format only)

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