Student Conduct Incident Report Form

If you need to report an emergency, do not use this form. Instead, call the University Police Department at (304) 766-3181.

This Incident Report Form is available to any person who wishes to report a suspected violation of the Student Code of Conduct.

If you wish to report a crime, please contact the University Police Department at (304) 766-3181.

**Information submitted through this form outside normal business hours (8:30 a.m.-5 p.m.) may not be reviewed until the next business day.**

Background Information
Your full name:
Your position/title:
Your phone number:
Your email address:
Your physical address:
Date of incident (Required):
Location of incident:
Involved Parties
Name or organization:
Select Gender:
Select Role:
Student ID Number:
Date of Birth:
Phone number:
Email address:
Residence Hall/Addresss:
Description/Narrative
Please provide a detailed description of the incident using specific, concise, objective language. Please refrain from using pronouns (he, she, etc.) to refer to people in the body of the report. Be sure to document specific language and behaviors rather than your opinions or judgments about the person's language and behaviors. In other words, please document precisely what you heard or saw rather than offering your opinion that a person's behavior was rude, for example. If alcohol was involved and alcohol containers are present, please indicate the type, quantity and whether the containers are full, partially full or empty. If a student appears to be under the influence of alcohol or other drugs, please describe the specific signs of intoxication (such as watery, bloodshot eyes; slurred speech; odor of alcoholic beverages; etc.) rather than simply indicating that the student appears to be intoxicated or drunk. If a student admitted to consuming alcohol or drugs, please document this information for each student.
Description of incident (Required):
Supporting Documentation
Photos, video, email, and other supporting documents may be attached below. Attachments require time to upload, so please be patient after submitting this form.
Choose filles to upload:

Student Conduct Incident Report Form

Background Information

Involved Parties

Description/Narrative

Supporting Documentation

Events Calendar