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BSU/NTC Confidential Report Form for Sexual Misconduct, Dating/Relationship Violence, Stalking


Thank you for reporting. Your safety is of the utmost importance to us. If you wish to make a formal University Security or police report, OR if this is an EMERGENCY, immediately contact BSU Public Safety at (218) 755-3888 or the Bemidji Police Department by dialing 911. Contacting police does not require you to pursue legal action.

Reports submitted here are not continually monitored and will typically be reviewed on the next business day.

This form is intended for use by students, employees, faculty, vendors, visitors or other concerned parties of both BSU and NTC to informally or anonymously report specific information related to incident(s) of sexual misconduct, dating/relationship violence and/or stalking. Sexual misconduct includes, but is not limited to, SEXUAL HARASSMENT, SEXUAL ASSAULT, SEXUAL EXPLOITATION, DATING/RELATIONSHIP VIOLENCE, and STALKING.

This is a secure reporting format accessible only to the appropriate BSU/NTC officials, including the Office of Diversity, Equity, and Inclusion and BSU/NTC Public Safety. You are not required to complete the entire form in order for the complaint to be submitted; however, you must complete fields denoted with an asterisk. The University will use the information provided to address the complaint, which can include an investigation and contacting the complainant, respondent and/or any potential witnesses. If the report does not contain specific information, the University's investigation and response may be limited.

For the victim/survivor reporting, it is your choice whether to remain anonymous, please know doing so may limit the University's ability address the matter and assist you. We strongly encourage you to access available resources, such as Support Within Reach (218) 444-9524, Office of Diversity, Equity, and Inclusion (218) 755-4121, Student Center for Health and Counseling (218) 755-2053, and the 24-hour crisis line (218) 422-0045.

Background Information

If you wish to identify yourself, please fill in the information listed below. If the person completing this form is the victim/survivor, you may choose to identify yourself or not. If you are a third party complainant who is not the victim, record your information below and record the victim’s name and contact information in the “Involved Parties” section.

 
Email address must be of a valid format.
This field is required.
This field is required.

List of All Parties Involved

Please provide identifying information about each individuals involved in the incident. Do NOT include the name or identifying information about the victim/survivor without permission.

Involved party 1

Questions

The following information is needed to proceed with an investigation that could lead to student or employee discipline. Information must be truthful; any individual knowingly providing false information may be subject to disciplinary sanctions and legal action. Complaints that are later found not to violate policy are not assumed to be false.

This field is required.
DID THE INCIDENT INVOLVE A SEXUAL ASSAULT? Policy definition: actual, attempted, or threatened sexual act without that person's consent that includes, but is not limited to: 1) Involvement without consent in any sexual act in which there is force, expressed or implied, or use of duress or deception upon the victim. Forced sexual intercourse is included in this definition, as are the acts commonly referred to as "date rape" or "acquaintance rape." This definition includes coercing, forcing or attempting to coerce or force sexual intercourse or a sexual act on another. 2) Involvement in any sexual act when the victim is unable to give consent. 3. Intentional and unwelcome touching, or coercing, forcing, or attempting to coerce or force another to touch a person's intimate parts (defined as primary genital area, groin, inner thigh, buttocks, or breast). 4. Offensive sexual behavior that is directed at another such as indecent exposure or voyeurism. CONSENT is informed, freely given and mutually understood. If coercion, intimidation, threats, and/or physical force are used, there is no consent. If the complainant is mentally or physically incapacitated or impaired so that the complainant cannot understand the fact, nature, or extent of the sexual situation, there is no consent; this includes conditions due to alcohol or drug consumption, or being asleep or unconscious. Silence does not necessarily constitute consent, and past consent of sexual activities does not imply ongoing future consent. Whether the respondent has taken advantage of a position of influence over the complainant may be a factor in determining consent.(Required)
This field is required.
DID THE INCIDENT INVOLVE DATING OR RELATIONSHIP VIOLENCE? Definition: Physical harm or abuse, and threats of physical abuse, arising out of personal intimate relationship. This violence may also be called domestic abuse or spousal/partner abuse and may be subject to criminal prosecution under Minnesota state law.(Required)
This field is required.
DID THE INCIDENT INVOLVE STALKING? Definition: Conduct directed at a specific person that is unwanted, unwelcome, or unreciprocated and that would cause a reasonable person to fear for her or his safety or the safety of others or to suffer substantial emotional distress.(Required)
This field is required.
DID THE INCIDENT INVOLVE NON-FORCIBLE SEX ACTS? Definition: Unlawful sexual acts where consent is not relevant, such as sexual contact with an individual under the statutory age of consent, as defined by Minnesota law, or between persons who are related to each other within degrees wherein marriage is prohibited by law. INDICATE OTHER OFFICES OR AGENCIES INFORMED OF THE INCIDENT?(Required)
This field is required.
WHICH OFFICES OR AGENCIES HAVE BEEN INFORMED OF THE INCIDENT?
You must make at least one selection.
This field is required.

Supporting Documentation

Photos, video, email, and other supporting documents may be attached below. Maximum 1GB total Attachments require time to upload, so please be patient after you click to submit this report. 5GB maximum total size.
Attachments require time to upload, so please be patient after submitting this form.

Submission