Student Conduct Hazing Form

If you think the incident or your concern is an emergency, please call 911.

Please provide as much information as you can in the 'Description of Incident' section regarding the concern you are reporting. Once the form is received, the appropriate staff will review the report and act as necessary, which may include contacting you, the person reported, and any witnesses you have identified.

The information you have provided, including the identity of the individual of concern, will be kept confidential whenever possible. While we do everything we can preserve your anonymity, we cannot promise complete confidentiality

Submitted reports are processed during normal business hours. They are not monitored after hours, on weekends, or on holidays.

Reporter and Incident Information

Consent for storing submitted data *

Yes, I give permission to store and process my data
No, I don't consent to storing and processing my data

Your full name:

Your phone number:

Your email address:

Date of incident: *

Time of incident:

Location of incident: *

Involved Parties

Names and roles:

Incident Description

Please provide a detailed description of the incident/concern using specific, concise, objective language (who, what, where, when, why, and how). Please be professional, accurate and factual. Observations and facts are more useful than characterizations or labels. *

Hours

Jessa Michaels

jessa.michaels@montcalm.edu