Racial Profiling Survey
Exit this survey

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Thank you for taking the time to answer these questions. We will use your responses to advocate for legislative measures that will protect individuals from discriminatory traffic stops and police encounters, to identitfy jurisdictions where we may challenge race-based traffic stops in court, and to educate the public about the problem of racial profiling.

1. Please provide us with the following information about your encounter with the police:

Please provide us with the following information about your encounter with the police: City where encounter occurred
Location (Street/Intersection)
Date
Time of Day

2. What is your ethnicity and why do you believe it played a part in you being stopped?

What is your ethnicity and why do you believe it played a part in you being stopped?

3. What reason were you given for the stop? If no reason was given, please leave blank.

What reason were you given for the stop? If no reason was given, please leave blank.

4. What documentation, if any, were you asked to provide to the police?

What documentation, if any, were you asked to provide to the police?

5. Were you questioned and/or searched? Please describe.

Were you questioned and/or searched? Please describe.

6. As a result of the stop, were you:

As a result of the stop, were you: Given a verbal warning

Given a ticket or citation

Arrested

7. What police department did the officer who stopped you work for?

What police department did the officer who stopped you work for?

8. How long did the entire stop take?

How long did the entire stop take? Less than 10 minutes

11 - 30 minutes

30 minutes - 1 hour

More than 1 hour

9. Please provide us with your:

Please provide us with your: Name:
Address:
Address 2:
City/Town:
State:
ZIP/Postal Code:
Email Address:
Phone Number:

10. Would you like to be contacted so that you may provide us with more details about your encounter with the police?

Would you like to be contacted so that you may provide us with more details about your encounter with the police? Yes

Racial Profiling SurveyExit this survey

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