Incident Report

The form below is for submitting details of incidents of an antisemitic nature that have been directed at you; or incidents you have witnessed/overheard in a public setting. You may submit information on behalf of another person.
Please provide details in the space provided.

Name (required)

Email address (required)

Contact number

Date of incident

If the incident occured over a period of time, or is ongoing, please enter the approximate date of when it started.

Incident description

If you have any files pertaining to the incident (photos, documents etc), please upload here.
Maximum file size is 2MB. Only 'PDF' and "JPG' filetypes are accepted.

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