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  • Student Forms
    Sexual Harassment and Misconduct (Title IX) Reporting Form
    form section in Student Forms in Student Services
    Student Forms
    ... Q: Who can use this reporting form? A: Only current students, faculty or staff members of the Carolina University community may file a report via this form. If you are not a current CU community member, please contact the Title IX Coordinator at jonescl@carolinau.edu or 336-714-7958. Q: I am ...
    form question in Student Forms in Student Services
    Student Forms
    ... Q: Do I have to provide my name? A: No. You may elect to provide this report anonymously. However, please note that if you elect to report information anonymously, this may limit the University's ability to conduct an investigation. Additionally, anonymous reporting does not satisfy an employ...
    form question in Student Forms in Student Services
    Student Forms
    Your Full Name
    form question in Student Forms in Student Services
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    ID Number
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    Your Position/Title (If applicable)
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    Your Phone Number
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    Your Email Address
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    Your Physical Address (If different from the University)
    form question in Student Forms in Student Services
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    Nature of this Report
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    Date of Incident
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    Time of Incident
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    Location of Incident
    form question in Student Forms in Student Services
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    Specific Location
    form question in Student Forms in Student Services
    Student Forms
    ... Please list the individual(s) involved, including any witness and excluding yourself. Please complete as many fields as best you can for each individual(s). The Complainant is the individual who has reported experiencing harm as a result of another person's conduct that could constitute a viol...
    form question in Student Forms in Student Services
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    Name
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    Gender
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    Role in Complaint
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    Email Address
    form question in Student Forms in Student Services
    Student Forms
    If more than one person is involved, please included everyone providing the the same information as above.
    form question in Student Forms in Student Services
    Student Forms
    ...Please provide a narrative description of the information you seek to report. You may provide as much or as little information as you choose. Please be advised that information provided here may be shared with the person whose behavior is being reported, as well as with relevant University personnel...
    form question in Student Forms in Student Services
    Student Forms
    Which, if any, supporting agencies have been contacted in support of the persons involved in this incident(s)?
    form question in Student Forms in Student Services
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    Other
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    Supporting Documentation
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    What

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