Incident Report Please provide detailed information regarding the incident you are reporting. Once the report is received, a member of the Office of Student Integrity will investigate the incident and determine any appropriate action plans, which may include a meeting with the involved student and others involved in the incident. Please know that you as the reporting party may be contacted to provide further information. Due to FERPA regulations, you may not be made aware of the outcome of Student Integrity Proceedings. This incident report should be saved and submitted via email to [email protected]. Please allow up to 2 business days for the processing of your report. Any questions can be directed to [email protected] or 912.344.3300.

Reporting Party

Email

Phone

Incident Date

Incident Time

Incident Location

Involved Individual(s)

Student ID Numbers (907)

Email

COMPLETE THE NARRATIVE ON THE NEXT PAGE. USE AS MANY PAGES AS NECESSARY. EACH PAGE IS LIMITED TO 4500 CHARACTERS. Code of Student Integrity: These reports are received by the Office of Student Integrity. Describe in as much detail as possible the specific behaviors/alleged violations observed. Indicate specific words, phrases, and behaviors observed. Concerning Behavior: These reports are received by the Office of the Dean of Students. Describe in as much detail as possible the student behavior, or change in behavior, that prompted this report. Indicate specific words, phrases, and behaviors observed. Informational: These reports are received by the Office of Student Integrity and forwarded on to the appropriate office as necessary, including Housing & Residence Life, University Police, or the Title IX Coordinator. Describe the situation in as much detail as possible.

Incident Information:

Incident Information:

Incident Information: