Reporting offensive incidents

Council, government and democracy

West Wiltshire
District Council
Bradley Road
Trowbridge
Wiltshire, England
BA14 ORD
Tel. 01225 776655

Reporting offensive incidents

Racial or other offensive incidents can be reported to the Council using the online form below.

This form will be actioned by the Community Safety Officer and the Community Safety Partnership.

For more help or information about offensive incidents please contact: the community safety section on 01225 776655.

Offensive Incident Report Form

1. Was the incident based on any of the following grounds?

Racism
Colour
Nationality
Ethnic or national origins
Disability
Religion
Age
Gender
Size
Marital Status
Sexual Orientation
Other (please state)

2. Give a brief description of the incident, including what was said, gestures etc and why it was considered offensive. Please include the date and location.

When?
Where?
Details

For the Council to take action, it will help us to know as much as we can about the people involved in the incident. Any information you give us will be treated confidentially.

3. Your Details (please tick the option that applies to you)

I have directly experienced an offensive incident
I witnessed an offensive incident
I have been accused of discriminatory behaviour
Your Name
Your Address
Telephone Number
Email Address
Male
Female
Age

Physical Disability

YES
NO
Job Title (if employed by WWDC)

4. Please indicate your ethnic origin. (please select the appropriate option)

White

British
Irish
Other White background, please state

Black, or black British

Caribean
African
Other Black background, please state

Asian or Asian British

Indian
Pakistani
Bangladeshi
Other Asian background, please state

Mixed

White and black Caribean
White and black African
White and Asian
Other Mixed background, please state

Chinese or other ethnic group

Chinese
Any other, please state

5. Tell us about the person who you consider directly experienced the offence.

Their Name
Their Address
Their Telephone Number
Their Email Address
Male
Female
Their Age
Their skin colour / Ethnic group

Physical Disability

YES
NO
Job Title (if employed by WWDC)

6. Tell us about the person you consider was being offensive

Their Name
Their Address
Their Telephone Number
Their Email Address
Male
Female
Their Age
Their skin colour / Ethnic group

Physical Disability

YES
NO
Job Title (if employed by WWDC)

7. Please give us any other information that is relevant to this incident.

Other Information

8. What action, if any, do you think the Council could take to avoid an incident like this happening again?

Preferred action
YES, I do want to to know the outcome of this report.
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