In case of an emergency call 911
(Emergency includes: a crime in progress, an immediate threat etc.)
CMW is documenting hate incidents and discrimination because of Racism, Anti-Immigrant sentiment or Islamophobia. 

Reporting Hate and Discrimination is very Important because:

* Reporting may help prevent this happening again to you or someone else.  

* Reporting will provide a more accurate understanding of the state of Islamophobia, Racism and Anti-Immigrant sentiment in Waterloo Region. 

This information is being collected by the Coalition of Muslim Women of KW (CMW) and we will make sure that your personal information (name, contact info) and anything else that may identify you, will not be shared with anyone unless we have your permission. 
Questions 3,4 and 5 are the only questions you are required to complete, but giving more information will be very helpful.