Share your experience
Ithaca Asian American Association (IAAA) is a volunteer-based civic organization. It promotes, educates, and celebrates cultural heritage of Asian and Asian Americans. For more information, visit www.ithacaasian.org or or Facebook: Ithaca Asian American Association. Contact: iaaa607@yahoo.com
With the increased number of racially motivated harassment incidents in the area (our community members have been called “virus,” told "go back to where you came from,” and “you are corona”), IAAA has developed this form so community members who have experienced bias or hate can report these incidents. Individual, personal information will only be shared with supportive members of the Ithaca Asian American Association. It will not be shared publicly unless permission is granted. The information gathered will be used to advocate for assistance, advocacy, and education. Your general report (without personal identification) will be shared with local law enforcement agencies and/or to appropriate agencies with your consent. The incident details will also be posted on various social media platforms to better inform the community and encourage others to tell their stories. If you have any concerns or questions, please do not hesitate to contact iaaa607@yahoo.com. If the matter is urgent, please call 911.
Description of Incident *Please provide 2-3 sentences describing the incident. *
Family/Last Name *
First Name *
Email Address *
Gender ( optional)
Ethnicity *
Date of the incident *
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Time of the incident *
Time
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Site of Discrimination - where did it take place? include internet/online *
Types of discrimination (Click all that apply) *
Required
Suspected Reason for Covid-19 Discrimination (Click all that apply) *
Required
Would you like to make this incident public? If yes, it will be shared on social media. If not, it will only be shared with appropriate agencies and allies. *
Any Supporting Links(News Clips, Social Media Sites)
By checking this box, you give IAAA permission to use your story, without personal information, for referral, service, and advocacy. We will not share your personal information publicly without your written consent. *
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