Bias Incident Report Form
A Bias Incident is any activity against a person or property that is motivated by the offender's bias against race, color, ethnicity, national origin, sex, gender identity or expression, sexual orientation, disability, age or religion. Members of the IWU community who believe they have witnessed or been subjected to a Bias Incident should report that incident. This report form is used for data collection and community education purposes only. Reports may be completed online by using this form or by contacting the offices listed below. You may report the incident anonymously or with your name. All reports will remain confidential to the extent possible.

In the event that an action is believed to be a discriminatory conduct or hate crime, please contact a member of the Bias Response Team to assure that an investigation is initiated. The primary resource for:

Students is the Dean of Students Office;
Faculty is the Office of the Provost; and
Staff is the Human Resources Office.

Classification
Please check all that apply:
Category 1 The perpetrator is:
Category 2 Who was there?
Category 3 Have there been previous reports regarding the perpetrator(s)?
Category 4 Was the Bias Incident directed at:
Category 5 What Identity Group was the conduct directed towards? What type of bias occurred?
Please check all that apply
Category 6 Did the Bias Incident involve:
Category 7 Did the Bias Incident occur:
Category 8 Was the incident associated with a university-sponsored event?
Category 9 Do you know if the victims are?
Incident Details
Were you the victim or the witness of the Bias Incident?
When did the incident occur? Date:
(MM/DD/YY)
Approximate time:
If the incident happened on campus. Please provide further details.
Additional location details:
Please provide any other information regarding this incident you would like to share:
Contact Information
(optional)
Name:
Email Address:
Phone:
I prefer to be contacted by:
Are you a
If you have any photos or videos you can upload them here.
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