Sexual Misconduct Online Employee Report Form

Sexual Misconduct Online Employee Report Form
Vance Granville Community College (VGCC) is committed to providing a learning and working environment that promotes respect, responsibility, communication, collaboration, critical thinking and accountability in an environment free of sexual harassment, misconduct, and discrimination and related retaliatory acts.

Anyone who has experienced or has knowledge of an instance of sexual harassment, misconduct, discrimination or retaliatory acts and wishes to report it, may do so using this form. Information shared on the form will be delivered confidentially to VGCC Title IX Coordinators.
Background Information
Date of Incident*

MonthDayYear
Date
Time of Incident*

Hour Minutes

AM/PM Option
Location of Incident*
Name*

First NameLast Name
Phone Number*
Please enter a phone number at which you can be reached.
Email*
example@example.com
Did you experience sexual harassment , discrimination or misconduct?*

YesNo
Please describe the nature of your complaint in detail
Nature of Complaint:
I understand that this information will be used to conduct an investigation. I understand that the College will make every effort to protect the privacy of all involved.
Consent*

I give my consent to reveal my identity to others to further the College's investigation and enforcement activities.I do not give my consent to reveal my identity to others to further the College's investigation and enforcement activities.
Should be Empty:

Background Information