White Supremacy related Written Comments Form

For those that are unable to attend the 6/9 and 7/14 White Supremacy, Domestic Threats & Youth Extremism Community Listening Sessions and would prefer to send your information to us via this link, please feel free to do so. After the event, you may also add additional information that you may have not had a chance to share, if you do attend.

You may also connect with us at communityrelations@njcivilrights.gov.

Are you a minor (under the age of 18)?*

If you are a minor, please provide your parent's first name and letter of the first initial of last name, email address and phone number below.

Participant's Name*

i.e. Jane S. | Note, If you do not wish to identify yourself, you may use your initials if you are under the age of 18. If you are over the age of 18, you can use your initials or a pseudonym (a fictitious name). If you use a pseudonym, please put an asterisk (*) before the name you enter in the field above to indicate that the name is a pseudonym.

Participant's Email Address*

example@example.com

If under the age of 18, please provide your parent's first name and first letter of the last name.

Parent's Email Address

example@example.com

Parent's Phone Number

Please enter a valid phone number.

Please share your personal stories/experiences of bias, prejudice and/or discrimination related to white supremacy and/or domestic terrorism. You may submit this written comment without identifying yourself.

Differently Abled (Optional)

Gender/Gender Identity (Optional)

Race/Ethnicity (Optional)

Religion (Optional)

Sexual Orientation (Optional)

Important Information

The content of all written and oral remarks and comments may be subject to disclosure under the New Jersey Open Public Records Act and may be included in the final written report.
Should you have any questions or feedback, please call 609-376-9740 or send an email to communityrelations@njcivilrights.gov.

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