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Online Homophobic/Transphobic
Crime Reporting Form
The experience of hate
crime is still a reality of many LGBT people
in London, yet less than 20% of such incidents
are reported. And if no-one knows hate crimes
are taking place, it makes it very difficult
to tackle the problem.
This form is designed
to make it quick and easy for you to report
homophobic or transphobic crimes to us. You
can choose whether you would like any of the
details of the crime to be passed on to the
police, either for monitoring purposes or for
an investigation. However, if you would like
the crime to be investigated you must provide
your personal information.
Even if you do not want
us to pass on specific details of the incident,
the information is still very valuable as it
helps us to compile anonymous statistics about
where crimes are being committed and work towards
reducing the problem in the borough. We will
not pass information to any other organisations
without your permission.
Information provided
in this form is submitted over a secure connection.
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What
would you like us to do with the information
you supply in this form? (Please
select one option)
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Please
note that fields marked with *
must
be completed.
ABOUT THE INCIDENT
Where did the
crime/incident take place? *
What was the
approximate time/date of the incident?
*
Please provide
details of the incident *
Why do you think
the incident/crime took place?
All the remaining sections of the form are optional.
However, we would appreciate as much information
as you feel you can give, and we ask that you
are frank and honest.
ABOUT YOU
Name
Address
Phone number
Age
Gender
What is your sexual
orientation?
Do you consider
yourself to have a disability?
How do you define
your ethnicity?
ABOUT THE PERPETRATORS
How many perpetrators
were there?
What gender were
they?
If you can, please
supply a description of the perpetrators, including
any distinguishing features etc.
Do you know the
identity of the perpetrators?
Are you prepared
to inform the police of the identity of the
perpetrators?
ABOUT ANY WITNESSES
Were there any
witnesses to this incident?
Please provide
details about the witnesses.
ABOUT THE PAST
If this is part
of an ongoing crime, please provide a brief
history.
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Would
you like any of the following organisations
to contact you? We will need to pass on
your name and contact details, but not
the information about the crime you have
given us.
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CONCLUSION
Please check
the box below to confirm the information you
have given. *
By checking this
box I confirm that the information provided
in this form is, to the best of my knowledge,
correct.
Please provide
your email address for confirmation purposes.
We will not record this unless you have given
consent for us to use your personal info.
Email address
*
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