Bias Incident Reporting Form

Your Information

Enable additional features by logging in.

Your full name:

Are you faculty/staff/student:

Your cell phone number:

Your Swarthmore email address:

Email address must be of a valid format.

Type of Incident(Required):

This field is required.

Learn more

Please identify a general area of behavior

Possible Motivation(Required):

This field is required.

Learn more

What do you think motivated the incident? For example: race, sexual orientation, disability, etc...

Date of incident(Required):

This field is required.

Time of incident:

Location of incident(Required):

This field is required.

Specific location:

Involved Parties

Please enter in all of the information you know about any people (NOT including yourself) involved in the bias incident.

Name or Organization

Select Role

Incident Narrative

Please provide all details that you have to the best of your recollection.

Please describe the offender(s)'s appearance, including but not limited to: name, sex, approximate height and weight, skin color, hair and eye color, facial hair descriptions, what they were wearing as far as clothing, glasses or no glasses, and other distinguishing characteristics.(Required) This field is required.

Please describe what you know about this incident and how this occurred.(Required) This field is required.

Please list any additional witnesses or impacted community members (and how we might contact them). This field is required.

Supporting Documentation

Photos, video, email, and other supporting documents may be attached below. 5GB maximum total size.
Attachments require time to upload, so please be patient after submitting this form.

Your Information

Involved Parties

Incident Narrative

Supporting Documentation

Submission