Conduct Reporting Form

Please to not use this form in place of calling Campus Safety (757)822-7777 or 911 if immediate assistance is required. After emergency intervention has occurred, please complete this form.

This form is for students, faculty, staff, and community members to report incidents involving TCC students where a policy violation may have occurred or concerning/threatening statements or behaviors have been witnessed. This form will be reviewed by Student Affairs staff members during normal business hours; follow-up will occur as needed.

Do not use this form to report sexual misconduct or discrimination. Please use the Sexual Misconduct Title IX Complainant Form. If the information provided involves mental health or criminal activity, the appropriate staff members will be notified to review information and provide support.

"*" indicates required fields

Reporter Information

Name

First Last

Phone

Email*

Enter Email Confirm Email

Your role at TCC

Would you like someone from Student Affairs to reach out to you regarding this incident?

Yes

At the conclusion of the case

Background Information

Type of Incident

Date of Incident

Time

Location

Specific Location

if other, please specify

Involved Parties Information

Student Name

First Last

Student ID Number

If known

Student Email

If known

Incident Information

Please provide a description of what occurred and provide as much information as possible.

Photos, video, email, and other supporting documents may be attached below.

Drop files here or

Max. file size: 32 MB.