Bias Incident ReportHome / Bias Incident Report Your Name (optional) First Last Your Position/Title Email Your Affiliation with Mason* Student Staff Teaching Faculty Administrative Faculty Alum Other Date of Incident* MM slash DD slash YYYY Time of Incident* : Hours Minutes AM PM AM/PM Location* Who was involved?NameEmailRolePhone Number Type of Incident* Assault Vandalism/Destruction of Property Discrimination Graffiti Harassment Threat/Intimidation Other If you selected "Other", please describe Nature of Bias* Age Gender Identity and Expression Race Sexual Orientation Ability Status National Origin Religion Veteran Status Other If you selected "Other", please describe Describe what happenedWho else, if anyone, has been notified of the incident?Supporting Documentation: Photos, video, email, and other supporting documents may be attached below. Drop files here or Select files Accepted file types: jpg, png, pdf, doc, docx, mp4, m4v, Max. file size: 50 MB, Max. files: 5.
