Title IX/SIM Report

Please take your time and provide as much detail as possible, but exercise care to not provide details that may reveal your identity unless you wish to do so. It may be important to know if you were the only person aware of this situation.

What is your affiliation with ETBU?

Do you wish to remain ANONYMOUS for this report?

If you want ETBU to know your identity, please complete the following:

Your Name

email:

Phone Number:

Best time for communication with you:

Please identify the person(s) engaged in this behavior: Example: John Doe, Director of Internal Audit

What is the general nature of this matter? This should be a general description only.

Where did this incident or alleged violation occur?

Please provide the specific or approximate date and time this incident occurred:

How did you become aware of this alleged violation?

Please provide all details regarding the alleged violation, including the locations of witnesses and any other information that could be valuable in the evaluation and ultimate resolution of this situation.