DOS Student Conduct & Community Standards

Background Information

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Your full name:

Your position/title:

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Your phone number:

Your email address:

Email address must be of a valid format.

Your physical address:

Urgency of this report(Required):

This field is required.

Date of incident(Required):

This field is required.

Time of incident:

Location of incident(Required):

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Specific location:

Involved Parties

Please list the individuals or organization involved (excluding yourself). Please note that if you do not know or choose not to provide the name of the individual(s) or group that you are reporting, the University may be limited in its ability to address the allegations.

An individual/organization listed as "Alleged" is the party who may have violated policy. One listed as a "Victim" is the individual/organization to whom the misconduct was directed; one listed as a "Witness" is an observer to the incident; one listed as "Reporter" is who informed you about the incident.

Name or Organization

Select Gender

Select Role

UIN

DOB (YYYY-MM-DD)

Phone number

Email address

Hall/Address

Questions

When reporting, please be prepared to provide the following information as best as you can:

What is the name of the organization that you are reporting for acts of hazing?

When did the event(s) occur?

Where did the event(s) take place?

What time of day did the event(s) occur?

Who was involved in this event?

Are there any other people that either were present or can corroborate the information you are providing? Please provide their names and contact information (if available).

How did you become aware of the event(s)?

Please describe the event(s) in as much detail as possible.

Please provide any documentation or photographs you may have.

Your name, phone number, and e-mail address

What team or organization are the individual(s) a member of?(Required) This field is required.

Please provide a detailed description of the incident/concern using specific, concise, objective language.(Required) This field is required.

How did you become aware of the act(s) and/or event(s)?(Required) This field is required.

Are there other individuals who could corroborate the information that you are providing? If so, please provide their names and contact information, if available. This field is required.

Have you shared information with others about this incident? If so, who have you communicated with? This field is required.

What is the resolution or set of resolutions you are seeking as a result of submitting this report?(Required) 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

DOS Student Conduct & Community Standards - Hazing Reporting Form

Background Information

Involved Parties

Questions

Supporting Documentation

Submission