Phone: (360) 681-3701 Fax: (360) 203-3507

Information provided in this survey is for data collection purposes only. No identifying information will  be collected. This information allows WSC to understand the size and scope of missing indigenous  women in Washington State. While data may be shared with other agencies, including law  enforcement agencies, this is not a missing’s person report. If you would like assistance contacting law  enforcement about a missing person, or would like to provide more information, please review the  Missing Persons Information Form here Missing Persons Form

If you would like to provide more information about your experience with Law Enforcement, please fill out the Law Enforcement Survey.

    Date Missing:

    Age at time of disappearance

    Federally Enrolled?

    YesNo

    Tribal Affiliation:

    Last Known Location:

    City and/or County of Residence:

    Biological Sex (M/F):

    Gender Identity:

    Please provide as much information as possible. If you don’t know an answer, simply skip the question  and move on to the next. Please provide tribal affiliation information regardless of enrollment status.

    Do not provide any identifying information on this form, such as names, nick names, addresses or  distinguishing features.

    This form is for data collection purposes only.

    Thank you for helping WomenSpirit Coalition better understand how many people are missing in Indian Country. We will continue to fight for our missing relatives.

    WomenSpirit Coalition
    10049 Kitsap Mall Blvd Ste. #304
    Silverdale, WA 98383
    [T] 360 683 7083
    [F] 360 286 2357