Report harassment if you have seen it happen to a student

Use this form to report harassment if you have seen it happen to a student...

  • Please write as much as you can remember.
  • If there are tick boxes, you can tick more than one if you wish.
  • When you give us information, it will be sent to the Human Rights Commission. They will study the information and it will be used by members of the Safer Students Team to help keep others safe.

Information about what happened (the incident)

1. What happened exactly?

How did it start? What did people say?

2. Why do you think the person was saying or doing hurtful things – what do you think they were thinking?

3. When exactly did it happen?

Can you remember: The time? The day of the week? The date?

4. Where did it happen?

Can you remember: The name of the street? Any names of buildings or shops close by? A letter box number close to you at the time?

5. Vehicles

Was there a car?    Yes      No

If yes, can you remember: What colour it was? The company that made the car? The model of the car? The licence plate number? Even a few numbers from the licence plate can be helpful. Anything else you can remember noticing about the car?

6. Please describe the person or people who got insulted or hurt

What did they look like?

For example...

  • Man or woman
  • Ethnic background?
  • How old?
  • Anything else?

7. What did the person or people who did it look like?

For example...

  • What did the person who did it look like?
  • Was the person who did it alone, or was there more than one?
  • How tall or short?
  • How thin or big?
  • What colour eyes and hair?
  • What kind of haircut?
  • What kind of clothes?
  • What colour were the clothes?
  • About how old did they look to you?
  • Ethnic background?
  • Is there anything else you noticed about the person or people who did this?

You can choose to write their name and contact details here if you wish.

8. Was anyone physically hurt?

  Yes      No

If someone was hurt, what kind of injury? How badly were they hurt?

9. Was any property lost or damaged?

  Yes      No

If so, what was damaged?

10. Do you usually feel safe living in Christchurch?

  Yes      No

General information about you

This could be helpful to understand more about harassment in Christchurch.
This information will not be linked with your name unless you choose to fill in the last section.

11. What is your age group?

 17- 20 years      21-25 years      26-30 years      31-40 years      40+

12.What is your gender?

 Male      Female      Other

Your contact details

If you are happy to be contacted by someone to follow this incident up, please include the following details.
If you don’t want to be contacted, leave this section.

Name: 
Address: 
Telephone number: 
Email: 
Student number: 

How would you like to be contacted?
(e.g. only at a certain time or place)

If you are contacted, information you give will not be given to anyone else, or any other organisation, unless you want them to.

 

 

Report harassment

Saying or doing hurtful things to people because they are different is called harassment. In New Zealand harassment is against the law.

Report harassment if you are a student, and it has happened to you »

Report harassment if you have seen it happen to a student »