Report an antisemitic incident

  • INSTRUCTIONS: Use this form to document antisemitic incidents that you have witnessed or personally experienced. If a friend or family has told you about an antisemitic incident, encourage them to fill out the form as well. Please indicate if you are reporting an incident on someone else’s behalf.

    You can submit multiple reports.

    ALL FORMS ARE KEPT CONFIDENTIAL.

    Your contact information is used internally for follow-up questions and/or to offer support.

    *Required



    Contact Information: Please provide your contact information, in case we need to contact you for clarifications and/or action follow-up.
  • Contact Information

  • Description of Incident

  • Please describe what happened. Be as specific as possible. Provide exact quotes and examples, if possible.
  • Note: Please provide the name of the institution, i.e. the name of the high school, college campus, community center, etc. If this happened online, please indicate the social media platform, i.e. Instagram, Facebook, Twitter, other.
  • Photos and Videos

  • Please email any photos and videos documenting the incident to masha@clubz.org with the subject line: "Antisemitic Incident Report”
  • About You

 

Verification