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Title IX / Sexual Misconduct Violation Report Form


I declare that the information I submit is true and accurate to the best of my knowledge and that false reporting for the purpose of slander or other malicious intent would be a violation in itself and have certain ramifications.

Violations reported using this form are submitted electronically and routed initially to Indiana Tech’s Title IX Co-Coordinators Chris Dickson, associate vice president of Student Services and Julie Hendryx, director of Human Resources. Timeframes and policies for investigations, definitions, and potential outcomes are all defined on the Title IX webpage.

Please note that this form is typically monitored Monday through Friday during regular university hours. If an emergency exists, please contact 911 and/or Campus Safety and Security at extension 2230.

Background Information

Please enter the information requested to the best of your ability. Anonymous reports may be submitted by leaving non-required fields of this section blank but it will increase the difficulty in investigating or validating the claim.

 
Email address must be of a valid format.
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Involved Parties

Please list the reported students first, followed by victims if applicable, followed by witnesses if applicable, followed by any staff or others if applicable. 

Involved party 1

Questions

Title IX / Sexual Misconduct Category:(Required)
You must make at least one selection.
How is the reported violator affiliated with the university?(Required)
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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.

Submission