TEST BUILDER

What to Report

It is a goal of the Communal Security Group to identify and assess any potential threats to our Community. It is extremely important to report incidents as soon as you witness them. Keep in mind we are collecting all information that affects our Community to include antisemitic behavior and acts. Please use this form to report all suspicious activity and antisemitic acts. This information will be reviewed and shared with the appropriate local, state and federal law enforcement for action and resolution.

If you SEE something, SAY something!

Suspicious activities, people and vehicles

Unusual events or incidents

Dangerous situations

Suspicious communications

(text messages, phone calls, voice mail messages, emails, letters or packages, etc…)

Familiarize yourself with what suspicious activity looks like.
Refer to the Incident Report Guide for detailed instructions in reporting suspicious activity.

Did the incident occur at or involve a college or university campus?(Required)

Yes

Which college or university does this involve?(Required)

Name of Other(Required)

What's your affiliation with the institution?(Required)

Current undergraduate student

Current graduate or professional school student

Current post-doctoral student

Current faculty

Current employee

Family member of person associated with the institution

Other

Please describe(Required)

Do you consent to sharing your identity and contact information with the Jewish Faculty Resilience Group (JFRG)?(Required)

JFRG is an organization that can connect you with resources and services to provide support.

No, please don't share my identity or contact information with any third party.

Yes, please share my identity and contact information with JFRG.

Maybe. Can you tell me more?

Choose an Option(Required)

I need to file an incident report

I want to file a general statement that is not about a specific incident

Please use this space to describe your general experiences or feelings about anti-Jewish and/or anti-Israel activities on campus.(Required)

Date of Incident

MM slash DD slash YYYY

Time

Hours

Minutes

AM/PM

What was the nature of the incident? (check all that apply)

Grafitti

Physical Violence

Visual Threat of Violence (i.e., carrying a weapon, raising a fist, touching inappropriately)

Verbal Threat of Violence

Verbal Abuse

Vandalizing, damaging property

Bullying

Digital post

Intimidating/Shaming

Boycotting

Isolating, marginalizing

Stalking

Menacing (crowding around someone in a threatening manner)

Encouraging others to commit violence or oppression of Jews

Blocked Access/Segregation

Indoctrination with political or religious views during academic activities

Biased or inappropriate course content

Pressure or harassment by Teaching Assistant, Professor, Coworker

Other

Other (please specify)

Location of incident (be specific)

Were there any witnesses other than yourself?

Yes

I don't know

Was a police report filed?

Yes

List any documentary evidence you have of the incident

Photo

License plate number

Screenshot

Other

Other (please specify)

Can you describe the offending individual?

Yes

I did not see the person

Gender

Male

Female

Unsure

Apparent age

Estimated height

Estimated weight

Complexion

Hair color

Eye color

Mustache

Beard

Glasses

Scars

Tatoos

Jewelry

Clothing

General appearance (dirty, well-groomed...)

Was there a vehicle involved?

Yes

Make

Model

Year

Color

License plate number

State

Direction of travel

Occupants

Chronological statement of what occurred(Required)

Important: Be precise with the timeline of specific events that occurred. Describe appearances, behaviors, weapons, signage, speech (use quotes if possible), types and locations of injuries.

Detail how this experience affected you mentally/emotionally. If you required medical care, please provide details.

How did this incident affect you physically? If you required medical care, please provide details.

Did the incident have consequences on your ability to function academically, occupationally, interpersonally, or socially? If so, please describe how and for how long, in as much detail as possible, and if you can, please provide examples.

Please let us know if you have already submitted reports of this incident to the following organizations (so we can avoid duplication of records):

I did not report to any other organization

Staff from a Jewish campus organization (eg, Hillel or Chabad staff member)

School staff or faculty member

School's Office of Diversity, Equity and Inclusion (DEI)

Dean of Students

Pittsburgh Police, 911

Anti-Defamation League (ADL)/Hillel: https://www.reportcampushate.org/

StandwithUs: https://www.standwithus.com/report-an-antisemitic-incident

Other

When did you submit the report(s), and how did the organization(s)/department(s) respond? What did they say/recommend?

What resources do you think would help you most right now?

Upload Supporting Images or Documents

Drop files here or

Max. file size: 128 MB, Max. files: 10.

First Name

Last Name

Your email address(Required)

Your phone

What is the best way to follow up with you?

Text

Voice call

Please, do not contact me.

Name

This field is for validation purposes and should be left unchanged.

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