Student Conduct Complaint

Background Information

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Your full name:

Your position/title:

Your phone number:

Your email address:

Email address must be of a valid format.

Your physical address:

Source of Complaint(Required):

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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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Specific location:

Involved Parties

Please list the individuals involved (excluding yourself) and provide information in as many of the listed demographic fields as you can provide, including student ID #, address, date of birth. If you do not have access to such demographic information, continue to submit the report and that information will be researched once the report is received.

For non-students, please list a Drivers License number in the block labeled ID if available.

Name or Organization

Select Gender

Select Role

ID Number

DOB (YYYY-MM-DD)

Hall/Address

Complaint Details

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. 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

Complaint Details

Supporting Documentation

Submission