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WIROC Incident Report
Please use this form to let us know about any faith-based act of bigotry or violence against you, someone you know, or a member of your community. We will make every effort not share any details with anyone else until we have talked with you. Please note that we are not a substitute for talking to law enforcement. If you feel that you, or someone you know is in danger, please call 911.

We will be in touch with you as soon as possible.

Email address *
First Name
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Last Name
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Phone Number
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Email Address
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Briefly describe the incident
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What is the best way to be in touch with you? *
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