POWERline - Report
Take back your power. Report harassment and discrimination in El Segundo.
I am:
The person who experience hate/harassment/discrimination
A witness to hate/harassment/discrimination
This incident involved (check all that apply):
El Segundo Business Owner or Employee
El Segundo City Employee
El Segundo Police Employee
El Segundo School Official
A member of, or visitor to, the El Segundo Community
Other (Please Specify Below):
Date the incident occurred (mm/dd/yyyy):
Approximate time the incident occurred:
Where the incident occurred:
Business
Online
Street/Sidewalk
Public Transportation
Place of Worship
Private Residence
School
Other (Please Specify Below):
Share further location details here (e.g. school site, specific business, intersection, etc.):
How would you characterize the motivation behind the incident? (check all that apply):
Anti-Black/African American
Anti-Latino/Hispanic
Anti-Asian
Anti-LGBTQIA+
Anti-Muslim
Anti-Native American
Anti-Disability
Anti-Gender or Gender Expression
Anti-Immigrant
Other (Please Specify Below):
Please describe in detail what happened:
Please provide us with your name. This information will not be shared unless express consent is provided:
Would you be willing to be contacted by a member of the Sweat Equity Alliance?
Yes
No
If yes please provide your preferred contact information(this information will not be shared unless expressed consent is provided).
Email Address:
Phone Number:
Would you like to make this report public? (If so, please provide your preferred contact information above in case we need to reach you for further details.)
Yes
No
Do you agree to share your story with the Sweat Equity Alliance?
By checking the "Agree" box below, you give Sweat Equity Alliance (SEA Change) permission to use your story, without personally identifiable information, for publication or use in our materials. SEA Change will aggregate data for the purposes of tracking hate/harassment incidents, analysis, reporting, and public education. We will not share your personal information publicly without your written consent.
I agree
I do not agree
Thank you! Your submission has been received!
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