Bias Reporting

*A note to faculty and staff: Please ensure you are logged out of the CSE website user profile before submitting to guarantee anonymity. If you are currently logged in, a "Logout" button will be visible in the upper right-hand corner on the black bar across the top of this page. 

Required fields are marked with an asterisk (*).

Provide specifics of date, time and location of incident including building, floor number of building, room number or address.   If the incident occurred in association with a specific department, program, athletic team or student club or other WWU-affiliated organization, please also list that information below.
Share any specific information regarding the person(s) involved in the incident you are referring including their role (alleged perpetrator, victim/target, witness, other) and their affiliation to WWU. If their identity is not known, please describe with any information you have.

Describe each incident of bias separately. For each incident provide the following information: 1) date(s) the action occurred; 2) name of individual(s) involved; 3) what happened; 4) witnesses (if any); 5) why you believe the action was bias, and 6) how this conduct impacted you. 

Examples may include comments, conduct, gestures, markings, physical injuries, property damage, etc. If known, please share any information you have about individuals and/or groups involved with incident.

What type of response would you like to see as a result of reporting this incident?
Unlimited number of files can be uploaded to this field.
16 MB limit.
Allowed types: gif, jpg, jpeg, png, bmp, eps, tif, pict, psd, txt, rtf, html, odf, pdf, doc, docx, ppt, pptx, xls, xlsx, xml, avi, mov, mp3, ogg, wav, bz2, dmg, gz, jar, rar, sit, svg, tar, zip.
I certify that the information provided in the form is correct and accurate to the best of my knowledge.