Please enable JavaScript in your browser to complete this form.Name *Email *Phone *Choose Category *Anti-Muslim hateAntisemitismAnti-Christian hateAnti-Buddhist hateAny other type of hateType of incident (please tick as many as apply) *Abusive BehaviourThreatening BehaviourAssaultVandalismDiscriminationHate SpeechAnti-Muslim LiteratureOnline content or abuseDate and time on which incident happenedDateTimePlease provide a brief description of incident *Location *Address Line 1CityState / Province / RegionPostal CodeCountryAfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBolivia (Plurinational State of)Bonaire, Saint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongoCongo (Democratic Republic of the)Cook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Kingdom of)EthiopiaFalkland Islands (Malvinas)Faroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHondurasHong KongHungaryIcelandIndiaIndonesiaIran (Islamic Republic of)IraqIreland (Republic of)Isle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea (Democratic People's Republic of)Korea (Republic of)KosovoKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesia (Federated States of)Moldova (Republic of)MonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth Macedonia (Republic of)Northern Mariana IslandsNorwayOmanPakistanPalauPalestine (State of)PanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint Martin (French part)Saint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint Maarten (Dutch part)SlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyrian Arab RepublicTaiwan, Republic of ChinaTajikistanTanzania (United Republic of)ThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUgandaUkraineUnited Arab EmiratesUnited Kingdom of Great Britain and Northern IrelandUnited States Minor Outlying IslandsUnited States of AmericaUruguayUzbekistanVanuatuVatican City StateVenezuela (Bolivarian Republic of)VietnamVirgin Islands (British)Virgin Islands (U.S.)Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland IslandsCountryUpload a photo/video of the incident (25 MB maximum) Click or drag files to this area to upload. You can upload up to 5 files. Did this incident happen to you? *No, I am a witnessNo, I am reporting on behalf of someone elseYes (please fill out your details below)GenderMaleFemaleNon-binaryOtherUnknownSelect Age GroupUnknown12 and younger13-1819-2526-3536-4546-5556-65Over 65Ethnicity1. Unknown---------- White ----------2. British3. Irish4. Irish Traveller or Roma5. Any other White background---------- Black / African / Caribbean / Black British ----------6. African7. Caribbean8. Somali9. Any other Black background---------- Asian / Asian British ----------10. Indian11. Pakistani12. Bangladeshi13. Chinese14. Sri Lankan15. Afghan16. Any other South Asian background---------- Mixed / Multiple ethnic groups ----------17. White and Black Caribbean18. White and Black African19. White and Asian20. Any other Mixed / Multiple ethnic background---------- Other ethnic group ----------21. Arab22. North African23. Jewish24. Any other ethnic groupPlease provide information about the perpetratorGenderMaleFemaleNon-binaryOtherUnknownMultiple/GroupSelect Age GroupUnknown12 and younger13-1819-2526-3536-4546-5556-65Over 65Ethnicity1. Unknown---------- White ----------2. British3. Irish4. Irish Traveller or Roma5. Any other White background---------- Black / African / Caribbean / Black British ----------6. African7. Caribbean8. Somali9. Any other Black background---------- Asian / Asian British ----------10. Indian11. Pakistani12. Bangladeshi13. Chinese14. Sri Lankan15. Afghan16. Any other South Asian background---------- Mixed / Multiple ethnic groups ----------17. White and Black Caribbean18. White and Black African19. White and Asian20. Any other Mixed / Multiple ethnic background---------- Other ethnic group ----------21. Arab22. North African23. Jewish24. Any other ethnic groupHow did you hear about us? *Word of MouthIn the pressOnline/Social MediaReferred by PoliceReferred by Another Organisation'Stop/Report' Wallet CardSearch EngineOtherSubmit