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Reporting a Hate Crime

Please answer the questions in the form below, clicking on the NEXT button to proceed to the next page of the form. When you have completed the form please click on the SUBMIT button.

(Mandatory questions have a * next to them)

iCM Form
  1. Your Details
  2. Agency contact for help or support*
    1. Do you consent to this information being shared with the Safer Working, Healthier Communities working group? *
    2. If "Yes" which information may be shared?
  3. Please proceed to the next page
  4. Label