Witness Statement Form

Your Information

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Your full name:

Your phone number:

Your email address:

Email address must be of a valid format.

Your physical address:

Date of incident(Required):

This field is required.

Time of incident:

Location of incident(Required):

This field is required.

Specific location:

Involved Parties

Name or Organization

Gender

Individuals Role

Phone number

Email address

Your Statement

LEHIGH UNIVERSITY HONESTY STATEMENT

Lehigh University expects that all the information you present will be true, complete, and correct. If you intentionally provide false or misleading information to the investigator or the hearing panel in this case, you will be in violation of the Lehigh University “Expectations of Conduct”; specifically, Expectation IV: “Respect for the Lehigh University Community”, and you will be subject to disciplinary action for providing false information.

The accused student or organization will receive a copy of this statement prior to any hearing or resolution of a disciplinary case. The Conduct Officer, a University Hearing Panel, and members of the Dean of Students Office may have access to this statement as part of a judicial case.

You may be contacted to meet with a member of the staff and you may be called as a witness at a hearing

If you are being accused of violating the code of conduct you are not required to provide a written statement

Please provide a detailed description of the incident that explains what you saw, heard, and experienced directly.(Required) This field is required.

Is there other information (e.g., a background story that explains the context, information you have come to learn since this incident, etc.) that you would like to provide? This field is required.

What is your relationship to the people involved in this situation (e.g., friend of the accused, roommate of the victim, do not know any of the people involved personally, etc.)?(Required) This field is required.

Supporting Documentation

Photos, video, email, and other supporting documents may be attached below. Maximum 12 megabytes per file Attachments require time to upload, so please be patient after you click to submit this report. Please upload anything you have that is relevant to this case. 5GB maximum total size.
Attachments require time to upload, so please be patient after submitting this form.

Your Information

Involved Parties

Your Statement

Supporting Documentation

Submission