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Public/Student Concern or Comment Form

This report is intended for both the general public and students to voice their concerns or comments about their observations of the Edgecombe Community College Campus Community. Once this form is completed, Edgecombe administration will take appropriate action based on the report; therefore, this should only be used if a credible issue has arisen.

If this is an emergency, please contact the appropriate emergency responders as well by dialing 911.

ECC prefers that all reports made in Maxient not be anonymous. However, if you care to make an anonymous report due to the circumstances of your matter please type “Anonymous” in the “Your Full Name” field. Keep in mind that there will be limited options for investigation of Anonymous reports.

Background Information

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Your full name:

Your phone number:

Your email address:

Email address must be of a valid format.

Your campus location:

Nature of this report(Required):

This field is required.

Urgency of this report(Required):

This field is required.

Date of incident(Required):

This field is required.

Time of incident:

Location of incident(Required):

This field is required.

Involved Parties

Name or Organization

Select Gender

Select Role

Phone number

Email address

Questions

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

Questions

Supporting Documentation

Submission