Student of Concern / Incident Report

Call 911 or Campus Police first in case of emergency

 

If you have a concern about a student, you are encouraged to notify the Behavioral Intervention Team using the incident report form below. If you have any questions regarding filing an incident report, please contact the the BIT team directly at (928) 428-8342.

When completing this form, please include your name, title, and contact information and provide as much detailed information regarding the incident as possible. Although anonymous reports may be submitted, we encourage you to include your contact information so that we may follow up with you for any further information or clarification that may be necessary.

Once an Incident Report has been received by the Behavioral Intervention Team, it will be reviewed by a team member, who will take appropriate action, which may or may not include contacting the student, you, and any witnesses you have identified. College disciplinary records are protected by a federal privacy law called the Family Educational Rights and Privacy Act. For reports involving College staff or faculty members, please contact the BIT team directly at (928) 428-8342.

Please select the appropriate Nature of this report from the drop down menu. The options are described below:

  • Student Code of Conduct: relates to alleged violations of the Code of Conduct;
  • Issues of Concern: relates to issues concerning the well-being of a student and are forwarded to the Behavioral Intervention Team;
  • Housing and Residence Life Conduct: relates to alleged violations of Housing Terms and Conditions;
  • Campus Security Generated: relates to issues submitted by Campus Security personnel;
  • Housing and Student Life Generated: relates to issues submitted by Residence Life staff (i.e. Head Resident, Hall Assistant, ASEAC Advisor, Student Life Assistant);
  • General College Complaint: relates to issues not concerning student behavior

 

Background Information










 

Reason(s) for Report

Code of Conduct Violation
  • Acts of dishonesty
  • Disruption or obstruction
  • Acts of abuse or intimidation, harassment or threats
  • Sexual assault or harassment
  • Theft or attempted theft or damage to property
  • Hazing
  • Failure to comply
  • Unauthorized use of any College key(s)
  • Entering or remaining in any building or area within a building without authorization
  • Violation of College policies, rules or regulations
  • Violation of the law
  • Manufacture, use, possession or distribution of illegal drugs
  • Conspiracy to manufacture, use, possess, distribute or conceal illegal drugs
  • Possession, use, manufacture or distribution of alcohol
  • Conspiracy to possess, use manufacture or distribute alcohol
  • Possession of weapons
  • Possession of other dangerous or prohibited articles
  • Demonstrations, which disrupts the operations of the College
  • Disorderly conduct
  • Lewd, lascivious or indecent conduct
  • Aiding, abetting, procuring or conspiring to breach the peace
  • Theft or abuse of computing resources
  • Misuse of the campus telecommunications systems
  • Abuse or contempt of the Judicial system
  • Other

College Complaint
  • Disability Accomodations
  • General College Complaint
 

Code of Conduct Violation - Housing
  • Excessive noise
  • Unregistered guest(s)
  • Smoking in college building
  • Burning candles or incense
  • Harboring pet(s)
  • Unauthorized cooking equipment / heaters
  • Bicycles/motorcycles in building or room
  • Storage of gasoline/oil products in room
  • Unauthorized room switches
  • Other

Issues of Concern
  • Change in demeanor
  • Disruptive behavior
  • Drastic change in appearance
  • Emotional distress
  • Health and wellness concern
  • Threats
  • Unauthorized room switches
  • Other

 

Involved Parties

Please list the individual(s) about whom you are reporting or about whom you have a concern

 

Please list any witness(es) to the incident or actions about which you are concerned

Check here if names are unknown

 

Description / Narrative

Please provide a detailed description of the incident/concern using specific concise, objective language.

 

Additional Questions

Was Campus Police contacted? Yes No

If yes, did they respond? Yes No

If Campus Police responded, approximately how long did that response take?

Other questions you may have for BIT

 

Supporting Documentation

Do you have any supporting documents/evidence in reference to your report? Yes No

If yes, please provide email and/or phone contact information below. BIT will contact you to coordinate retrieval of documents/evidence

 

The Behavioral Intervention Team can be contacted in non-emergency situations at (928) 428-8342.