Complete the below form to report an incident of concern at IUP.
*Required fields
(The person making the report)
First Name*
Last Name*
Phone
E-mail Address*
Banner ID
Location of the Incident
If you selected Other above, please provide the other nature of the incident:
If you selected Other above, please provide the other basis for the incident:
Describe the Incident in Detail
List first and last name(s) of perpetrator(s) if known.
List witnesses and others involved if known. Please include first and last names, their role (target, third party, or observer), phone number and e-mail for each if know.
Have you reported this incident to any other office on campus? If yes, which one(s) and on what date(s) report(s) were made?
Do you have any additional information that might be relevant to this incident?