SEXUAL MISCONDUCT & DISCRIMINATION REPORT

Please submit this form to report an incident of discrimination, harassment or assault to the Title IX office. You may submit this form anonymously, however, our ability to respond to the incident may be limited. It is our practice to reach out to the reporting party (and/or the victim if different and known) to explore the report and options prior to opening any formal investigation. Items marked with an “*” are required.

If this is an emergency please call 911 immediately!

Your Name
First Last
Your Role on Campus

Student, Staff, Faculty, RA, etc.
Your Email
(Your valid email address must be entered to receive a copy of this report.)
Your Phone
Nature of This Report (Required)*
Date of Incident*
MM slash DD slash YYYY
Time of Incident

: Hours

Minutes

AM/PM
Location of Incident*
Specific Location If Known
Involved Parties
Please list the name of all parties involved.
- Responding Party: those who are being reported to have violated college policy
- Complainant Party: the name of the party or parties who are being reported as victims
- Witness Party: any potential witnesses to the event(s).
Include any identifiable information about each person that is known to you.
Name
First Last
Contact information (phone, email, address)
Role
Add Another Party?
- Yes
- No
Name
First Last
Contact information (phone, email, address)
Role
Add Another Party?
- Yes
- No
Other Parties
Please list any further involved parties and their role, with as much contact information for each involved party as you can provide.
Incident Description
Please provide a detailed description of the incident/concern using specific concise, objective language (Who, what, where, when, why, and how if known).
Required*
If you are not the complainant/victim, is that person(s) aware that you have submitted this report?*
- Yes
- No
Supporting Documentation
Upload supporting documentation
Photos, video, email, and other supporting documents may be attached here. Attachments require time to upload, so please be patient after submitting this form. File size limit is 8MB.
Drop files here or

Max. file size: 2 MB.
Would you like an emailed copy of this report?
Your valid email address must be entered at the top of this form to receive a copy of this report.
- Yes
- No
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Sexual Misconduct & Discrimination Report

Involved Parties

Incident Description

Supporting Documentation

Manhattan Christian College

Campus

Resources

Community