McPherson College: Incident Report


Harassment Incident Report
This form is provided for students, staff, and faculty to report incidents of harassment both on and off campus. In addition to sexual harassment, harassment also involves unwanted physical, verbal, or electronic contact and may involve comments and/or actions related to race, ethnicity, religion, or sexual orientation.

Date/Time:
Location:
Describe Incident:
Those Involved:
Check all that apply : This is an issue about which the campus needs education
Dean of Students needs to pursue contact with those involved
Please contact me
I only wanted to make you aware of the incident

(optional)
Name:
Phone:
Email: