MU Equity
Bias Reporting

Bias Incident Report Form

Please use this form to report electronically - and anonymously if you so choose - a bias incident that has occurred within the MU community.

If you have witnessed or experienced an act committed against any person, group, or property which you believe discriminates, stereotypes, harasses, or excludes anyone based on some part of their identity, please report it to the MU Equity Office using this form.

Identity may include race, color, ethnicity, religion, disability, nationality, language, gender, sexual orientation, group affiliation, and other similar factors.

You may use this form regardless of the severity of the incident (i.e., any incident, including hate crimes, can be reported here).

However:

1) What transpired during the incident? Please check all that apply:

Verbal Assault
 Harassment
 Vandalism
 Theft
 Unequal Treatment
 Accessibility
 Discrimination
 Email/Internet Messages
 Physical Contact
 Written Hate Speech
 Threats
 Public Indecency
 Stalking
 Intimidation
 Physical Assault
 Retaliation
 Sexual Assault
 Unwanted Sexual Conduct
 Graffiti
 Fear for Safety
 Property Damage
 Pursuit-Chase
 Threat of Outing
 Other
*If other, please specify:

2) What type of bias occurred?


*If other, please specify:

3) In the following text box, please describe the incident as completely as possible.

Provide all relevant description, including dates and times; location; who was there, and, if known, whether participants are faculty, student, or staff; what the sequence of events was; what if anything was said; what action was taken and whether other appropriate officials have been notified; etc.

4) Association with the incident

5) Affiliation with MU

*If other, please specify:

Note: the identifying information below is optional. Without this information, the form will be submitted anonymously.

If you provide your contact information, we will contact you to follow-up on this report. If you do not provide contact information, there is no way for us to identify who is submitting this report.





If you can see this, leave the next text box blank. It is here to trick the bad guys.

You may always report a bias incident in person or contact the Director of MU Equity directly to receive information, assistance, or referrals. You can reach Noel English at 573-882-9069, or .