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Report Discrimination
Have you been the victim of direct or indirect anti-Muslim harassment or discrimination either at work, in the school or in public places? Report these incidents to MPAC to enable us log and take action where required. Such incidents of harassment or discrimination may be attitudes you encounter at job interviews, tones of voice, stares, teasing or inappropriate jokes, conversations which suddenly stop when you enter the room, subtle forms of exclusion, or inappropriate and frequent references to Islam and emotional “buzzwords" like Islamists, Islamic militants, Jihad/Jihadists, holy Jihad, Muslim Extremists, Muslim Terrorists, Fundamentalists, etc. Please try to fill in as much detail as possible. MPAC respects your privacy & confidentiality and will not disclose your details to a third party without your prior consent. For more information, please contact us at
alert@mpac-ng.org
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Your Name
Your Address
Your Telephone Number
Your Email
Description
Was the incident reported to the police or any other agency?
Yes
No
If so which?
What was the outcome?
*
Comment
*
Date of filling in this form
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Recorded by
*
Would you be happy for us to include this case in our reports on abuses and discriminations against Muslims
Yes
No
Would you like an MPAC case worker to contact you?
Yes
No