Sexual Misconduct 'Report It' Form

Background Information

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Your full name:

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This can be intentionally left blank and submitted anonymously.

Your title, if applicable:

Your phone number:

Your email address:

Email address must be of a valid format.

Your physical address:

Date of incident(Required):

This field is required.

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If the exact date is unknown, please use today's date.

Time of incident:

Location of incident(Required):

This field is required.

Specific location:

Involved Parties/Witnesses

Please list the individuals involved (excluding yourself), completing as many of the listed fields as possible.

Name (first and last preferred)

Select Gender

Select Role

ID Number

DOB (YYYY-MM-DD)

Phone number

Email address

Hall/Address

Questions

Reason(s) for Report (check all that apply):(Required)

Sexual Harassment Sexual Assault Domestic Violence Dating Violence Stalking Different Treatment Discrimination Hostile Environment Harassment Retaliation and/or Intimidation

You must make at least one selection.

Please provide a narrative of the incident, providing as much detailed information as possible.(Required) This field is required.

Supporting Documentation

Photos, video, email, and other supporting documents may be attached below. 5GB maximum total size.
Attachments require time to upload, so please be patient after submitting this form.

Email me a copy of this report

Background Information

Involved Parties/Witnesses

Questions

Supporting Documentation

Submission