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Student Conduct Report

The Student Code of Conduct identifies behavioral expectations for all Western students in support of a positive learning environment. If you have knowledge of any Western student potentially violating the Student Code of Conduct on campus or in the community, you are encouraged to notify the Student Life Office. The Student Code of Conduct and the Student Code of Conduct Hearing procedures can be found in the Student Handbook.

Please use this form to report any alleged violations of the Student Code of Conduct. Reports submitted anonymously may limit our ability to address the concerning behavior.

If the incident involves sexual or gender-based misconduct or harassment, please submit here or contact Ge Vang, Title IX Coordinator, at 608-785-9444 to file directly.

If you have any questions about filing an conduct report, please contact the Student Life Office at 608-785-9445.

Background Information

Your full name:

Your position/title:

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Ex. Student, staff, faculty, other)

Your phone number:

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Please include area code

Your email address:

Email address must be of a valid format.

Date of incident(Required):

This field is required.

Time of incident:

Location of incident(Required):

This field is required.

Specific location:

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(Ex. 1st floor restroom, Room 101, etc.)

Involved Parties

Please complete as much information as possible for each person involved in incident including their roles (ex. alleged violator, witness, complainant, etc.). For Western students, please include the zeros in the student ID number (ex. 001234567).

For non-students: Please use last name first name (no spaces or commas) in the ID Number field, and if person attends another institution, enter the institution name under Room Number (Ex. John Smith would be SMITHJOHN)

Name or Organization

Select Gender

Select Role

ID Number

Phone number

Email address

Incident Detail

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

Background Information

Involved Parties

Incident Detail

Supporting Documentation

Submission