Please fill in the information below and submit to the Office of Student Conduct as soon as possible after the alleged incident has occurred (preferably within 2 University business days).  This form should be submitted to the Office of Student Conduct (OSC) which is located in the Lillard Administration Building, room 211 and 213 / Box 158, or online at

Please describe the facts about the incident.

Other Involved Persons
(Please specify the role of each person as a “witness,” “alleged victim,” “accused,” or “other”)

Person 1

Person 2

Additional Parties (If applicable):

Person 3

Person 4