Friday, April 14, 2006

Racist Incident Reporting Form Page 4

31. What was the outcome?

32. How satisfied are you/the person who experienced racism with this outcome?

] Very satisfied ] Unsatisfied []Satisfied ] Very unsatisfied []Neutral [] Unknown

33. Why are you satisfied/unsatIsfled with this outcome? ________________________________________

(go to question 35)

34. Why wasnt the incident(s) reported?

35. Would you/the person who experienced racism like the Confronting Racism in Communities Project Officer to contact you to discuss available complaints mechanisms and support services?

O Yes (please remember to provide your contact details on page 1 of this form)O N0 CJ Unsure IFor workers

36. Did you provide any information or support to the person who experienced racism?

D yes ONo

If yes, what kind of information or support did you provide?Please return this form to:

Katherine Moriarty Confronting Racism In Communities Project

Officer Centre for Multicultural Pastoral Care

PO Box 112 Paddington QId 1064Tcl: 07 3876 3294 or 07 5459 4804Mobile: 0137 180 724Fax: 07 3369 3094

Email: confrontingracisn’tyahoo.com.au

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