Report An Incident

CAIR CAN HELP! If you or someone you know has experienced religious discrimination, a civil rights violation, or has been contacted by law enforcement, please report the incident to us using the form below.

Report an Inicident

Your Name(Required)

First Last

Victim Name (If Filling on Behalf of Someone Else)

First Last

Your Email(Required)

Email of Victim (If Filling on Behalf of Someone Else)

Your Phone Number(Required)

Phone Number of Victim (If Filling on Behalf of Someone Else)

Your Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Gender of Victim(Required)

Date of Birth (Victim)

Religion of Victim

Ethnic Background of Victim

Education Level of Victim

Immigration Status of Victim

Date of Incident

County Where Incident Took Place

Location of Incident(Required)

Perpetrator Information(Required)

Ex. Name, Gender, Address, Contact Information

Detailed Description of the incident(Required)

I am reporting an incident but I do NOT want legal assistance

Have you contacted an attorney or other organization regarding your problem? If so, who and when?

By submitting this online complaint form, you understand that the Council on American-Islamic Relations, New Jersey (CAIR-NJ) is not agreeing to represent you in any manner. You also understand and agree that CAIR-NJ is not responsible for ensuring that any statute of limitations requirements are met in your case or that any court deadlines are met in any currently pending case or other legal proceeding you may have. You further understand that CAIR-NJ will not be representing you unless and until both a representative of CAIR-NJ and you have signed a written agreement. Until such an Agreement has been signed, CAIR-NJ will only be assessing and investigating whether it can provide you with representation or other assistance.

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Report An Incident

CAIR CAN HELP! If you or someone you know has experienced religious discrimination, a civil rights violation, or has been contacted by law enforcement, please report the incident to us using the form below.

Report an Inicident

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