Coronavirus Anti-AAPI Racism Incident Report / Daim ntawv soj ntsuam Kab mob Coronavirus Anti-AAPI kev ntxub ntxaug rau haiv neeg esxias
Nyob rau ob peb lub Asthiv dhau los no, lub ntiaj teb raug ib qho xwm txheej uas lub koos haum txhawb kev noj qab haus huv World Health Organization muab hu tias “Kev kub ntxhov thoob qab ntuj.” Lub sij hawm thaum tus kab mob Covid-19 tau kis loj tuaj, coob leej ntau tus neeg dub hau (Asian Americans) thiab cov neeg Pacific Islanders (AAPI) tau tshaj tawm tias lawv raug txoj kev ntxub ntxaug xws li raug thuam thiab nto, saib tsis taus vim sib txawv los ntawm nqaij tawv, thiab kev ntxub ntxaug los ntawm lwm pab pawg. Nyob rau Los Angeles, ib tug me nyuam ntawm lub nroog San Fernando Valley raug teeb meem xws li mag ntaus nyob rau nws lub tsev kawm middle school thiab raug lawv nto tias nws yog neeg muaj kab mob coronavirus yeeb vim nws yog neeg dub hau AAPI xwb. Nyob rau San Francisco, ib tug ntxhais hluas raug lawv nto qob ncaug rau thiab lawv liam tias yog tim nws coj kev kab mob coronavirus tuaj kis rau teb chaws Asmeskas. Tsis hais cov laus los cov hluas nyob hauv California no, lawv ntshai thiab txhawj txog tsam lwm tus yuav ntsia lawv li cov tsim teeb meem coj kab mob coronavirus tuaj los kis rau sawvdaws.

Muab cov teeb meem no zwm cia xa tuaj rau A3PCON thiab CAA uas yog siv daim ntawv teev tseg nyob rau hauv qab yuav pab tau peb thiab peb cov pab pawg sib txhawb los soj ntsuam cov xwm txheej no rau lub Xeev CA thiab thoob lub teb chaws. Yog tsis tau kev tso cai los ntawm nej, peb yuav tsis tso tawm nej cov ntaub ntawv rau lwm tus sab nraud thiab tsoomfwv nrog rau tej chaw saib xyuas kev ruaj ntseg paub.

Ua tsaug uas nej teev tseg nej cov teeb meem rau A3PCON thiab CAA.
First Name / Lub Npe *
Last Name / Lub Xeem *
Email Address *
Age / Hnub Nyug
(Optional) / (seb koj puas xav tso)
Gender / Poj niam los txiv neej
(Optional - Select one or multiple checkboxes)
City / Lub Nroog *
State / Lub Xeev *
Zip Code / Zauv koog tsev *
Ethnicity / Haiv neeg *
Organizational Affiliation / Qhia txog lub koos haum uas koj zwm tau
(Optional)
Date of Incident / Hnub uas teeb meem tshwm sim *
MM
/
DD
/
YYYY
Time of Incident / Sij hawm teeb meem tshwm sim *
Time
:
Site of Discrimination (Click all that apply) / Chaw uas kev ntxub ntxaug tshwm sim (khij txhua qhov uas raug rau koj) *
Required
Location/Address of Incident / Address- Chaw nyob uas teeb meem tshwm sim *
Type of Discrimination (Click all that apply) / Hom teeb meem uas tshwm sim (khij txhua qhov uas tshwm sim) *
Required
Suspected Reason for Covid-19 Discrimination (Click all that apply) / Xav tias kev ntxub ntxaug rau Covid-19 yog los ntawm yam twg (khij txhua yam uas muaj tseeb) *
Required
Description of Incident /Piav txog qhov teeb meem uas tshwm sim *
Please provide 2-3 sentences describing the incident. / Thov piav li 2-3 kab lus uas qhia txog qhov teeb meem.
Any Supporting Links / Puas muaj tej yam pov thawj uas txhawb tau qhov teeb meem
(News Clips, Social Media Sites) / (xov xwm)
Submit
Never submit passwords through Google Forms.
This form was created inside of Asian Pacific Policy and Planning Council. Report Abuse
Google Forms