Hazing and Organizational Misconduct Reporting Form

Background Information

The Office of Community Standards will do everything within it's power to maintain your privacy and anonymity as a reporting party. If you choose to not submit your name and contact information, your anonymity will be guaranteed and the Office of Community Standards will only be able to investigate the information you provide in the sections below which may significantly limit the ability of the Office of Community Standards to perform a comprehensive review of the concerns or allegations described.

We encourage you to include your contact information allowing the Office of Student Conduct to ask any clarifying or follow-up questions, as needed, and perform a more thorough investigation into the concerns.

Your full name:

Your phone number:

Your email address:

Email address must be of a valid format.

Your physical address:

When did the concerns occur?(Required):

This field is required.

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Did the incident you are concerned about happen in the past, or is it currently happening?

Date of incident(Required):

This field is required.

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if an exact date is not known, please identify an approximate date of the incident

Time of incident:

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if known, otherwise approximate or leave empty if you are significantly unsure

Location of incident(Required):

This field is required.

Specific location:

Involved Parties / Organization(s)

Name or Organization

Select Gender

Phone number

Email address

Hall/Address

Incident Description and Summary

Did you witness the concerns you are about to describe below directly, in person?(Required)

Yes No (I heard about them from another person)

You must make at least one selection.

Please provide a detailed description of your concerns regarding the conduct and/or behavior of the academic, social, team/athletic, or other organization.(Required) This field is required.

To your knowledge, was anyone injured during or from what you described above?(Required)

Yes, a student Yes, a non-student No

You must make at least one selection.

If someone was injured, please include their name and any contact information you may have, below, so we may ensure they are receiving the medical attention and care they may need. This field is required.

Would you like for someone from the Office of Community Standards to contact you, specifically, about your concerns?(Required)

Yes (please include your contact information in the section above)

I'm not sure (please contact the Office of Community Standards when you are ready at 909.748.8259)

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.

Background Information

Involved Parties / Organization(s)

Incident Description and Summary

Supporting Documentation

Submission