Alliance Against Islamophobia (AAI)

  • AAI Reporting Form

  • I want to:*

  • Your personal details

  • Format: 0000000000.

  • Please provide the on behalf of contact details in relation to this submission.

    You can contact on behalf of someone else. The person you are lodging this contact for must complete and return this form to allow us to discuss their contact with you. You may attach this form at the end of this contact or email it to support@comsaa.au. If they do not tell us you have their permission, we will not investigate your contact.
  • Title
  • Format: 0000000000.
  • Current Sector*
  • Type of incident?*
  • Type of online incident?*
  • Date of the Incident*
     - -
  • Online platform*
  • Provide the screenshot or link about the reported incident
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  • Who is filling out this form?*
  • Victim’s gender?*
  • Victim’s age group?*
  • Victim’s ethnic origin?
  • Was the victim wearing any religious clothing or other religious markers (eg. Jilbab, Hijab, kufi hat) at the time of the incident?
  • Perpetrator’s gender?*
  • Perpetrator’s age?*
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  • If you feel like you were affected by the incident, please select which emotions you felt?
  • Have you reported to:
  • Do you want the Register to forward your report to the Police?
  • How can we help you? (please select one of the following)
  • Do you want to receive CoMSAA's communication in the future?*
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  • Should be Empty: