Cal Poly Pomona Logo

Non-Academic Misconduct Incident Reporting Form


The Office of Student Conduct & Integrity is charged with upholding the Student Conduct Code, which identifies behavioral expectations for all students. Student Conduct & Integrity will investigate the incident(s) to determine if a violation has occurred and to assign outcomes when appropriate.

To report non-academic misconduct that occurs on or off campus, use this form. Examples of non-academic misconduct include, but are not limited to disruption, use of illicit substances, hazing, and theft.

To report academic dishonesty, use this form: Academic Dishonesty Reporting Form. Examples of academic dishonesty include, but are not limited to cheating or plagiarism.

To report students of concern, use this form: Students of Concern Referral Form. Examples of concerning student behavior include, but are not limited to sudden changes in mood or behavior, mental health concerns, or basic needs support. The Care Center will coordinate on the response to these concerns when appropriate.

When completing this form, please note that anonymous submissions may limit our effectiveness in responding to the behavior.

If you need any support submitting an incident report, please contact Student Conduct & Integrity at (909) 869-6985.

Please note that submissions of this form are not reviewed outside of business hours. If there is an immediate concern for health and safety, please call University Police at (909) 869-3070, or dial 911. 

Background Information

Learn more
E.g. staff, faculty, student, community member
Email address must be of a valid format.
This field is required.
This field is required.

Involved Parties

Please list the individuals or recognized student organization involved (EXCLUDING yourself). The Bronco ID Number MUST include all nine digits.

Involved party 1

Description of Incident

This field is required.
This field is required.

Supporting Documentation

Please provide any documentation for this incident (i.e., screenshots, emails, photos, etc.).

The file size limit of attachments is 5GB maximum total size.
Attachments require time to upload, so please be patient after submitting this form.

Submission