Hate Crime Report | PCC

PCC Hate Crimes and Bias Incident Report

Stop Hate Here

The college developed this form in order to obtain information about and respond to hate crimes and bias incidents on our campuses.

A Hate Crime: is any criminal act in which biased motive is a clear contributing factor. A hate incident is any act, including conduct, speech, or expression, in which biased motive is a clear contributing factor. Hate incidents do not have to include a criminal act.
A Bias Incident: is actions that are motivated by prejudice or hate, but may not meet the necessary elements required to be a crime.

Hate Crime Report Date of Incident: Approximate Time:

I wish to remain anonymous

( You do not wish to have your contact information submitted. )

Yes
No

Do you wish to be contacted by a college official?

Yes
No

First Name: Last Name: Email: Contact Phone:

Based on this information, are you a victim of a hate crime or bias incident?

Hate Crime
Bias Incident

Please describe the incident(s): Location:

The Person completing this form is:

Victim/Target
Family Member
Friend
Partner
Witness
PCC Employee

The person experiencing the intimidation, harassment, and/or discrimination is:

( Check all that apply )

Male
Female
PCC Employee
Non Student
Unknown

The incident was:

( Check all that apply )

I felt the bias incident or hate crime was because of:

( Check all that apply )

The person intimidating, harassing or discriminating was:

(Check all that apply )

Male
Female
PCC Employee
Non Student
Unknown

To your knowledge, was this incident or crime reported to any police agency?

Yes
No

If no, why?

Was the incident or crime reported to any other department on campus?

Yes
No

If no, why?

Is there any additional information PCC needs to know?

For additional help please contact Public Safety:

Emergency: 503-977-4444 (4444 from campus phone)
non-emergency: 503-977-4902