Reporting Form for Sexual Harassment, Sexual Assault, Intimate Partner Violence and Stalking

REPORTER CONTACT INFORMATION

Please provide your information so that a University official may contact you for more regarding this report.

Reporters Name:

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*Employees of Gonzaga University must complete this field

Reporters Title:

Your phone number:

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example: 123-456-7890

Your email address:

Email address must be of a valid format.

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example: jdoe@gonzaga.edu

Reporters Status:

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(Student, faculty, staff, community member, parent, other)

Nature of this report(Required):

This field is required.

Date of Incident(Required):

This field is required.

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If unknown, select today. If a date range, select estimated date the behavior began.

Please select a location(Required):

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Specific location:

Involved parties

Please take an opportunity to list all of the involved parties in this incident and their respective role in the incident(s). Reporting an incident will result in an initial outreach from the University for fact finding and initiation of the University process.

Name or Organization

Please provide the following information related to this person

ID number (if known)

Questions

Supporting Documentation

Please upload any Photos, videos, emails, text messages and any other support documentation. 5GB maximum total size.
Attachments require time to upload, so please be patient after submitting this form.

Email me a copy of this report

REPORTER CONTACT INFORMATION

Involved parties

Questions

Supporting Documentation

Submission