Hazing Reporting Form

Background Information

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Your full name:

Your phone number:

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:

Involved Parties

Please list the individuals and organizations involved, including as many of the listed fields as you can provide.

Name or Organization

Select Role

Phone number

Email address

Questions

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

What is your relationship to the people involved? This field is required.

What caused you to determine that the above listed group was involved? (i.e. Greek letters, direct involvement, colors, etc.)(Required) This field is required.

Is there any additional information you wish to provide? 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

Background Information

Involved Parties

Questions

Supporting Documentation

Submission