Title IX, Discrimination, and Harassment Reporting Form (DRAFT)

Provide Your Background Information

Thank you for completing this form. Although you may report anonymously, we encourage you to provide your name and contact information so we can provide you with additional resources and explain the processes available to you. While we will follow up to the extent possible with the information you provide, our ability to take remedial action may be limited should you choose to report anonymously.

Your full name:

Your position/title:

Your phone number:

Your email address:

Email address must be of a valid format.

Your physical address:

Nature of this report(Required):

This field is required.

When did this occur?(Required):

This field is required.

Where did this occur?(Required):

This field is required.

Office/Department:

Tell Us About Others That May Be Involved

Please provide details about others that are involved. Use the "Add Another Person" button if you need to include additional parties.

Name

Select Role

Phone number

Email address

Department/Office

Provide Incident Information

Please answer the following questions thoughtfully and honestly.

1. Describe what happened in detail.(Required) This field is required.

2. Did you notify law enforcement?(Required)

Yes, the local police where this occurred Yes, the Schoolcraft College Police Department Yes, both the local police and Schoolcraft College Police Department No, I did not notify any law enforcement body

This field is required.

3. If known, what is the complainant's (victim/accuser) relationship to the respondent (alleged/accused)? This field is required.

4. If you are submitting this as a witness/bystander, or on behalf of someone else, does that person know you are submitting a report?

Yes No Unsure

This field is required.

Confirmation of Understanding: By submitting this form, I certify that the information I have provided is true and accurate to the best of my knowledge. I understand that this data intake form, any correspondence, and all discussions pertaining to this complaint process are confidential to the extent permitted by law. I agree to abide by these guidelines.(Required)

I understand

You must make at least one selection.

Supporting Documentation

If you have supporting documentation but are unable to upload it when submitting the report, please let us know how/when you plan to submit it in the Incident Information Section of 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

Provide Your Background Information

Tell Us About Others That May Be Involved

Provide Incident Information

Supporting Documentation

Submission