Antiziganismus Meldung – Citizen Center of the Virtual RomaNation

Who? Who was involved in the incident? *

who

When? Date and time of incident *

Date

Time

When

How? Please make a selection *

Where?

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Website/URL

What kind of Antiziganism / Antigypsyism /Antiziganismus you want to report? *

Please describe the incident * *

What else would you like to tell us?

Here you can send us a file

Click or drag a file to this area to upload.

Handling of personal data *

Here you have to decide how we should handle your personal information.

I the reporter *

First

Last

Telephone *

E-Mail *

Contact info reporter

Address Line 1

City

State / Province / Region

Country

We would have to ask for a phone number and email. 1. We will contact you to exclude fake reports. 2. We also need the contact to inquire about further information on the report. 3. If you do not want this, you will remain anonymous, so nobody will find out from us who reported.