E-Report sa Gender Ombud

Name

Contact number

Email address*

Kailan nangyari ang pangbabastos? (Date of incident)

Age Group*

1 - 10 years old

11 - 20 years old

21 - 30 years old

31 - 40 years old

41 - 50 years old

51 - 60 years old

61 - 70 years old

71 - 100 years old

Sino ang nag-rereport (who is filing the report?)*

Victim survivor (biktima mismo ng pambabastos)

Bystander/witness/person with knowledge of the GBSH (nakakita o nakakaalam sa nangyaring pambabastos)

Concerned organization (organisasyon na may alam tungkol sa pambabastos at nais magreport/magdokumento)

CHR Office (taga CHR na nagdodokumento ng pambabastos)

MMDA/ASHE

Safe Spaces partner organizations

Barangay VAW/ASHE Desk

Sex assigned at birth of victim survivor*

Female

Male

Prefer not to say

Sector*

Contractual Employee

Domestic worker

Elderly/Senior Citizen

Formal Economy Worker (Regular Employment)

Government employee

Homeless person

Internally Displaced Person

LGBTQIA+ Commmunity

Migrant worker/former migrant workers

Minor

Person living with HIV

Rural Women

Solo parent

Student

Urban Poor

Woman with Disability

Women in armed conflict area

Women in detention

Worker in the informal economy

Ano ang naranasang pambabastos na nagdulot ng iyong pagkabalisa at pakiramdam na di ligtas (What kind type of sexual harassment did you experience that made you feel unsafe and uncomfortable)? *

Cat-calling, wolf-whistling (pagsipol,paghiyaw)

Misogynistic or sexist remarks or comments, online or offline (pagpapakita ng galit o pagkamuhi sa mga kababaihan, pangmamaliit/pagsasantabi sa kakayahan ng mga kababaihan sa pamamagitan ng komentaryo o pahayag online o offline)

Homophobic or transphobic remarks or slurs (pagpapakita sa sakita o sa kilos ng galit, pagkamuhi, pangmamaliit sa mga lesbiana, bakla, bisexual o sa mga transgender women or men)

Persistent unwanted comments or gestures on a persons' appearance ( paulit-ulit na mga hindi kaaya-ayang mga komento o kilos tungkol sa panlabas na hitsura ng isang tao)

Statements of sexual comments/suggestions, online or offline (mga pahayag o komentaryong malaswa o sekswal)

Relentless requests for personal details (walang tigil na paghiling sa mga personal na detalye)

Groping/unwanted touching and other lewd sexual actions (panghihipo, pang chancing)

Other unwanted verbal or physical advances threatening ones sense of personal space and safety (iba pang hindi kaaya-ayang pahayag, pisikal na pagsasamantala na nagbibigay ng takot at banta sa personal na espasyo at kaligtasan ng isang tao)

Stalking/cyberstalking/ incessant messaging (paniniktik sa pisikal o online at walang tigil na pagpapadala ng mga mensahe))

Request for sexual favors (paghingi ng mga sekswal na pabor)

Physical, psychological and emotional threats (pisikal, sikolohikal at emosyonal na pananakot)

Uploading/sharing without consent any form of media (pag-upload, pagbabahagi ng mga larawan at iba pang media content ng walang pagsang-ayon ng may-ari)

Impersonating identities online (panggagaya ng katauhan online)

Prefer not to say

Sino ang may gawa ng pambabastos? (Who committed sexual harassment?*

Acquaintance (kakilala)

Stranger (di kilala)

Boss/teacher

Iba pa

Where sexual harassment happened*

Streets and public spaces (e.g. parks, public terminals, train stations, bus, jeepney, malls etc., religious Institutions)

Online platform (e.g. Facebook, Twitter, Tiktok, IG, Youtube etc.)

Workplace (public and private)

Educational and Training Institutions (e.g. schools, universities, colleges)

Barangay where the gender-based sexual harassment happened (for GBSH in Public spaces)* * Metro Manila Barangays only

Online Platform where gender-based sexual harassment happened (for online GBSH)*

Facebook/Facebook messenger

Twitter

Tiktok

Instagram

Youtube

Others

Not Applicable

Name of place where SH happened*

Brief description of violaion*

Do you wish to

Report only and document (i-report lamang at i-dokumento)

Report and seek assistance (i-report at humingi ng tulong legal, counselling o imbestigasyon)

BAWAL BASTOS Form