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Categories
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Extreme Violence
Assault
Damage and Desecration of Properties
Threats
Abusive Behaviour
Anti-Muslim Literature
Threatening Behaviour
Vandalism
Discrimination
Hate Speech
Where did you hear about TELL MAMA?
Online
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Friends
TV Advert
Radio
YouTube
Social Media
Mosque
Publicity Material
Would you like us to contact you for future research?
Yes
No
Perpetrator Information
Age of Perpetrator
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10-20
21-30
31-40
Over 40
Unknown
Gender of Perpetrator
Male
Female
Unknown
Ethnicity of Perpetrator
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White British
White Irish
Any other White Background
Mixed White and Black Caribbean
Turkish
Polish
Mixed White and Asian
Any other Mixed Background
Black Caribbean
Somali
Arab
Black African
Any other Black Background
Indian
Pakistani
Bangladeshi
Any other Asian Background
Chinese
Gypsy or Traveller
Any other Ethnic Group
Jewish
About You (Victim):
Please list your Ethnicity from tab below
Select Ethnicity
White British
White Irish
Any other White Background
Mixed White and Black Caribbean
Turkish
Polish
Mixed White and Asian
Any other Mixed Background
Black Caribbean
Somali
Arab
Black African
Any other Black Background
Indian
Pakistani
Bangladeshi
Any other Asian Background
Chinese
Gypsy or Traveller
Any other Ethnic Group
Jewish
Were you wearing religious clothing during the incident?
Hijab/Niqab
No Identifiable Clothing to a Religion
Muslim Prayer Clothing - Male
Your Age
0-9
10-20
21-30
31-40
Over 40
Unknown
Your Gender
Male
Female
Unknown
Have you reported this incident to the Police?
Yes
No
In your opinion, did the perpetrators have any Far Right Links to Extreme Groups?
Yes
No
Unknown
If Yes, can you provide further details?
If Yes, can you provide details of the (Police) officer working on your case?
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First Name
Last Name
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