BIT Referral (Student Conduct Incident Report)

Tell us about yourself:

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Your full name:

Your phone number:

Your email address:

Email address must be of a valid format.

Urgency of this report(Required):

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Date of incident(Required):

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Time of incident:

Location of incident(Required):

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Involved Parties

Please list the individuals involved (excluding yourself), including as many of the listed fields as you can provide.

Person's Full Name

Gender Identity (select all that apply)

Student ID Number

Phone number

Email address

Please describe the concern (s) you would like to share.

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

Tell us about yourself:

Involved Parties

Please describe the concern (s) you would like to share.

Supporting Documentation

Submission