georgetown.secure.force.comGeorgetown University W-9 Registration Portal

Bias-Reporting Incident Form Any member of the Georgetown University community can make a report about a possible bias-related incident or hate crime through the Bias Reporting System or by calling the Department of Public Safety at (202) 687-4343. For questions or clarification, please visit the Bias Reporting System website at https://biasreporting.georgetown.edu/ * Name of Complainant/Witness Address * NetID * Email * Phone Number * Your Classifcation --None-- Undergraduate On-Campus Student Undergraduate Off-Campus Student Graduate/Professional Student Stall Faculty Other * Date & Time of Incident/Event [ 2/21/2020 2:22 AM ] * Incident/Event Location Type of Incident/Event (Please select all categories that apply to the event if any) Damage or Destruction of Property Physical Harassment or Assault Verbal Harassment Phone Harassment Written Harassment Email/Online Harassment Graffiti Sexual Assault Intimidation Vandalism Other Damage or Destruction of Property Physical Harassment or Assault Verbal Harassment Phone Harassment Written Harassment Email/Online Harassment Graffiti Sexual Assault Intimidation Vandalism Other Nature of Incident/Event (What bias do you feel was the target of the incident? Please select all categories that apply to the event if any) Age Gender Religion Race Disability Marital Status Sexual Orientation National Origin Ethnicity Gender Identity or Presentation Culture Veteran Status Ex-Offender Status Other Age Gender Religion Race Disability Marital Status Sexual Orientation National Origin Ethnicity Gender Identity or Presentation Culture Veteran Status Ex-Offender Status Other Detailed Description of Incident/Event (Please include all pertinent facts, behaviors, comments, gestures, markings, clothing, or distinguishing characteristics. For hard copy forms, please attach additional sheets if necessary) Was anyone physically injured? Yes No Do not Know Did anyone witness the event? Yes No Do not Know Please Contact me via --None-- Email Phone If you would like a specific member of the Bias Reporting team to review your incident, please select them below --None-- Academic Deans Campus Ministry Center for Multicultural Equity & Access (CMEA) GUPD Institutional Diversity, Equity, & Affirmative Action (IDEAA) LGBTQ Resource Center Residential Living Any of the Above January February March April May June July August September October November December 2019 2020 2021 2022 2023 2024 2025 Sun Mon Tue Wed Thu Fri Sat Today...