Student Group Conduct Incident Report Form

Reporter Information

Name and contact information of the reporting party is required as the reporting party will be contacted during the review process to learn more about the reported incident or violation. Anonymous reports can be filed through the University's confidential reporting service, EthicsPoint, however, these are not submitted directly to Student Unions & Activities and are not specific to Student Group violations.

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Your first and last name:

Position/Title/Affiliation:

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(Student, staff, faculty member, community member, other)

Your phone number:

Your email address:

Email address must be of a valid format.

Date of incident(Required):

This field is required.

Involved Parties

Please list the names of the student groups and individuals involved. Under "Select Role" please indicate whether they were witnesses to the incident or if they are accused of perpetrating a conduct violation or hazing.

Look up a student group ID number here.

Name or Student Group

Select Role

Student Group ID number

Phone number

Email address

Incident

Nature of report(Required) This field is required.

Location of incident(Required) This field is required.

Specific location (if not listed above) This field is required.

Date of incident(Required) This field is required.

Time of incident This field is required.

Please describe the incident or violation.(Required) This field is required.

What policy, regulation, or established practice is said to be violated? (View Student Group Policies or Student Conduct Code for specifics, if needed)(Required) This field is required.

Was alcohol involved in this incident?(Required) This field is required.

Did any injuries result from this incident?(Required) This field is required.

If so, please describe the injuries that resulted from this incident. This field is required.

Did you witness this incident or violation?(Required) This field is required.

What resolution are you seeking from this report?(Required) This field is required.

Have you shared information about this incident/violation with others?(Required) This field is required.

If so, with whom have you shared information? This field is required.

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

Reporter Information

Involved Parties

Incident

Supporting Documentation

Submission