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Hate/Bias Crimes Form

PLEASE NOTE: The form below is for reporting hate or bias type incidents or report material distributed with the intent to provoke bias or hate crimes, within the city of Glendale.  By completing this form, you acknowledge that you understand that this form is strictly to report hate or bias type incidents.

If a criminal act was involved (theft, assault, etc.), please click here for information on how to file a police/criminal report.

(Note: Fields indicated in bold are required.)
Location of Occurrence:
Please enter the location of occurrence.
Date:   mm/dd/yy
Please enter the date of occurrence, or approximate date.
Time:
Please enter the approximate time of occurrence.
Contact:
Yes    
No    
Please indicate if we can contact you or not.
Your Name:
If you will take contact, please enter your name.
Telephone:
Please enter a phone number where you can be contacted.
Comments:
Please enter information about the incident, giving details about what occurred.
 
Glendale, AZ - Welcome
Glendale, AZ