Anti-Hate Youth Collective Reporting Survey

Thank you for taking the time to participate in this survey. Your feedback will help us understand your experiences and encounters with racism or hate in Windsor-Essex.

Permission & Anonymity Statement
Your responses in this survey are strictly confidential and will be anonymized to protect your privacy.

By submitting this form, I give consent for my responses to be used for research and project purposes by the South Asian Centre of Windsor. My responses will remain anonymous and will not be associated with my identity.

Where have you experienced racism or hate? (Select all that apply) *

At school (Grade School, High School, University, etc.) Workplace Online Public place (Park, Place of Worship, Shopping Mall, etc.) Neighbourhood (Landlord, Neighbour, Tenant, etc.) Service Providers (Health care, Social Services, etc.) Other:

In your opinion, what is the reason for the incident? (Select all that apply) *

Ethnicity (Arab, Black, East Asian, Indigenous, South Asian, etc.) Faith/Religious background (Buddhist, Hindu, Jewish, Muslim, Sikh, etc.) Sexual Orientation (Lesbian, Gay, Bi-sexual, Trans, Queer, Two-Spirit, etc.) Other:

Briefly describe the incident. Please refrain from utilizing any personal identifiers (such as location or names). *

Have you/are you planning to report the incident? *

YES NO

If you wish to formally report this incident to the South Asian Centre of Windsor for assistance, please select “YES.” By choosing “YES,” you consent to the Centre contacting you through the method you provide in the form. Your responses above will remain anonymous. If you select “NO,” no further action or information will be needed. *

Yes, I would like the South Asian Centre of Windsor to assist me in formally reporting this incident and request further support in both reporting and receiving assistance. I consent to being contacted using the information I have provided and understand that this information will be kept strictly confidential. No, I do not feel comfortable in moving forward in the reporting process. My disclosure was simply just to tell others about my experiences. I understand that I will not be contacted further by the South Asian Centre of Windsor regarding my disclosure.

Thank you for taking the time to share your experiences with us. We understand that reporting incidents of hate can be difficult, and we respect your decision. Please know that your responses are completely anonymous, and no further action will be taken by the South Asian Centre of Windsor, as indicated by your preference. Your feedback is still valuable to us, and we appreciate your willingness to participate.

If you ever change your mind or need support in the future, please don't hesitate to reach out. We're here to support our Windsor-Essex community.

You can also safely report a Hate Crime or Hate Motivated incident to the Windsor Police Service. Click on this link to take you to Windsor Police Service Hate Reporting Site.

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Windsor-Essex Anti-Hate Youth Collective Reporting Survey