Incident Recording Form The information collected on this form will help track the frequency and nature of hate crimes and bias-motivated offensive conduct in the Boston College community. We encourage you to report incidents of hate to the Boston College Police or other designated authorities before using this form. See either the “If you have been a target of hate” or the “If you have been a witness” section of the Hate Crime and Bias-Motivated Offensive Conduct Protocol for further information about what should be reported and how to do so.
Now that you have accessed the form you may use it immediately or save it and fill it out at your convenience. Please fill out as many sections of the form as you can. Once the form is completed and saved, send it as an e-mail attachment using your BC email account to Richard Jefferson, Executive Director of the Office for Institutional Diversity at firstname.lastname@example.org . You may also print your completed form and hand deliver it to Mr. Jefferson at the Office for Institutional Diversity, 129 Lake Street, Room 211. Forms received via Campus Mail or U.S. Mail will not be accepted. The Office for Institutional Diversity will hold your identity in confidence in this process unless it determines that a felony may have been committed. If you have any questions about the form, its use, or the Hate Crimes and Bias Motivated Conduct Protocol, please contact the Office for Institutional Diversity at 617-552-2323 or visit the Hate Crime and Bias-Motivated Offensive Conduct web home.
12. Please identify/describe the location in the space below. Be as specific as you can.
(e.g. More Hall 3rd floor)
13. In the space below, please describe what happened in as much detail as you can, including times, locations, number of witnesses, and the details that make you believe the incident was hate-motivated.
14. What types of identity do you believe this incident was targeting (i.e., was it based on assumptions about race, sexual orientation, disability, etc.)? Please check all that apply.
Other (Please specify):
16. Was this incident reported to anyone? Yes No
If yes, to whom was it reported?
Were you satisfied with the result? Explain.
17. Would you like a trained advocate to contact you to follow up on this report? Yes No
If you answered yes to the last question, please write in the space below any contact information you would like us to have (name, telephone number, e-mail address, etc.) You do not have to enter this information to file a report.
Thank you for completing this form. If you wish to make changes or additions to your report at any time, please use this form again and check “Modification of an existing report” in question 6.