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Report Form for Discrimination, Sexual Misconduct and Retaliation


This form may be used by students, employees, faculty, vendors, visitors or other concerned parties to report specific information related to an alleged incident(s) of discrimination based on a protected class, including harassment, sexual misconduct and retaliation for making a report or participating in an investigation of the same. Sexual misconduct includes, but is not limited to, sexual harassment, sexual violence, sexual exploitation, intimate partner/dating violence and stalking. If this is an emergency please contact the Triton College Police Department at (708) 456-0300, ext. 3206, or if you are off campus, call 911. Contacting the police does not require you to pursue legal action.

This is a secure reporting format accessible only to the appropriate college officials. You are not required to complete the entire form in order for the complaint to be submitted; however, you must complete fields denoted with an asterisk. The college will use the information provided to address the complaint, which often includes beginning an investigation and contacting the complainant first and then contacting the respondent and any potential witnesses. If the report does not contain specific information, the college's investigation and response may be limited. Anonymous complaints without any contact information most likely cannot be addressed.

Students should review the Student Code of Conduct found here:
http://issuu.com/tritoncollege/docs/book4112012?e=5612353/1113640

The following terms are used below:

Reporter: The person who submits the report. The reporter may be the complainant, a witness or another person who knows about an incident or situation.

Complainant: The person who experienced the alleged violation or harm.

Respondent: The person accused of perpetrating the alleged violation or harm.

Witness: A person who saw or heard an incident occur or who has relevant information about it.

Mandatory Reporter: All College employees (with limited exceptions) including faculty, administrators, and staff, must report any incidents of possible sexual harassment, sex discrimination, or retaliation on campus of which they are aware. Reports must be made within 24 hours of receipt of information.

Background Information

If you wish to identify yourself, please fill in the information listed below.

If you experienced discrimination, sexual misconduct or harassment, you may choose to remain anonymous. If you are making this report on behalf of someone else, record your information below and record the names and contact information, if known, of all other parties in the “Involved Parties” section.

 
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For example: student, parent, faculty, etc.
Email address must be of a valid format.
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What is the role of the person about whom you are making the complaint?
This field is required.
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If you do not know the exact time, please estimate.
This field is required.
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For Example: Room B-120 of the B building

Involved Parties

Please state the name and other details (if known) of the person about whom you are complaining and any witnesses and/or other complainants.

Involved party 1

While providing details is essential to investigating your complaint, please be advised that some or all of the information you provide in this section may be shared with the person(s) about whom you are making this complaint.

Please indicate the type of complaint per your best estimation.(Required)
You must make at least one selection.
Per your best estimation, please indicate the reason(s) you believe you have been treated unfairly or otherwise violated. This form does not address general complaints related to conflicts in your academic or work environment that are not directly related to the following categories.(Required)
You must make at least one selection.
This field is required.
This field is required.
This field is required.
Do you believe you have experienced retaliation as a result of speaking to anyone about this incident or making a prior report?(Required)
You must make at least one selection.
This field is required.
Was a police report filed about this matter?(Required)
You must make at least one selection.
Have you discussed this complaint with any college official?(Required)
You must make at least one selection.
This field is required.
By checking the box below and submitting this form, you certify that the information you have provided is true and accurate to the best of your knowledge.(Required)
You must make at least one selection.

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