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Incident Reporting Form


This Reporting Form is NOT a 911 or Emergency Service:
Do not use this page to report events presenting an immediate threat to life or property. Reports submitted through this service may not receive an immediate response. If you require emergency assistance, please contact NC State Police at 919-515-3000 or dial 911.


Report an Academic Integrity Violation

Academic violations that include, but not limited to, cheating, plagiarism or falsifying official records related to the University. General classroom misbehavior is considered a non-academic violation. To report academic misconduct, please use the Report of an Academic Integrity Violation (RAIV) form.


Report Relationship or Interpersonal Violence, or Sexual Misconduct

Interpersonal violence includes dating violence, domestic violence, sexual harassment, sexual misconduct, or stalking behaviors. The Office of Student Conduct works with the Office for Institutional Equity and Diversity to address interpersonal violence concerns. To report interpersonal violence, please use OIED’s online reporting form.


Report Concerning, Worrisome, or Threatening Behaviors

Faculty, staff, students, and guests are encouraged to use the Online Referral Form to report behavior they perceive as concerning, worrisome, or threatening. For information on what is meant by concerning behavior, please visit the NC State CARES page and review on when to refer a student.


Report Community Climate Concerns and Bias Impact

The OIED Impact Response Team reviews reports of bias-related events, incidents, behavior or actions and supports restorative and educational responses to address the individual, collective, and institutional impacts. For more information about bias impact and impact response please visit the OIED Bias Impact Response page. To submit a report, please use the online form.


Not sure if a behavior is a violation or how to categorize it? Contact the Office of Student Conduct at 919.515.2963 or studentconduct@ncsu.edu.

Background Information

 
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Example: A101, Cates Ave., G20, etc.

Involved Parties

Please list individuals involved (EXCLUDING yourself), and as many of the listed fields as you can provide.

For non-affiliate persons, please list a Driver's License number in the block labeled SID if available. If you have listed your information as the person submitting the report, you DO NOT need to include duplicate information. The NC State ID MUST include all nine digits.

Definitions of Roles:

Respondent: student(s) or Student Group/Organization alleged to have engaged in conduct that violates the Code

Victim: person who has been impacted by the alleged behaviors of the Respondent

Witness: person who is able to provide information about the incident, but is not alleged to have engaged in a potential violation of the Code (RA, police officer, etc).

Involved party 1

Questions

Please provide a detailed description of the incident/concern using specific concise, objective language. If you have listed an individual as an involved person, they should appear at least once in the narrative. These reports are submitted to the Office of Student Conduct or appropriate University Housing area for resolution.

For matters involving Conduct violations, please provide as much detail as possible in describing the behaviors and activities that occurred. The use of direct quotes, including profanity or abusive language, is encouraged. Avoid using pronouns when multiple individuals are involved.

For FYI reports, please include as much description as possible regarding the circumstances that resulted in the report. These reports are generally reviewed by the appropriate staff member in University Housing.

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Select any of the following that apply:
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Was alcohol involved?
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Were drugs involved?
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Supporting Documentation

Please attach any relevant documents for your report.

We strongly recommend any additional information be either in JPG, PNG, and/or PDF format. Please do not submit HEIC files.

5GB maximum total size.
Attachments require time to upload, so please be patient after submitting this form.

Select copy recipients

(For police use only): If other departments or individuals should receive a copy of this report, please select them below:
(For police use only): If other departments or individuals should receive a copy of this report, please select them below:

Submission