Sexual Misconduct & Title IX Reporting Form

Reporter & Background Information

Note: Anonymous complaints will be addressed and investigated as warranted; however, the University’s ability to address complaints of this nature may be limited because of the inability to adequately investigate them. This applies not only to the Involved Parties information in the next section of this report, but to your information in this section as the reporter (aka referent) for this report.

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Your full name:

Your phone number:

Your email address:

Email address must be of a valid format.

Respondent's connection to UNT(Required):

This field is required.

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The Respondent is the person who is being accused of misconduct.

Clery reportability(Required):

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Must be a Clery crime AND in Clery geography (on campus or at a UNT Event) per clery.unt.edu

Date of incident(Required):

This field is required.

Time of incident:

Location of incident(Required):

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Specific location:

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Include extra information such as room number, off campus location, or other descriptor if known.

Involved Parties

Survivor: the person (or persons) to whom the alleged misconduct happened

Respondent: the person (or persons) responsible for the alleged misconduct

Witness: all persons who have directly witnessed the alleged misconduct

Person with information: any persons with relevant information who did not directly witness the alleged misconduct

Note:

As the person filling out this form you are considered the reporter (aka referent), so unless you were directly involved in the incident you will not need to list yourself in this Involved Parties section. However, if you were directly involved in the reported incident please include your information here AND in the Reporter & Background Information section above.

First and last name

Select role

Student ID number

Phone number

Email address

Report Information:

Supporting Documentation

This space may be used to attach relevant information such as pictures, videos, screenshots, or other materials related to this report. 5GB maximum total size.
Attachments require time to upload, so please be patient after submitting this form.

Email me a copy of this report

Reporter & Background Information

Involved Parties

Report Information:

Supporting Documentation

Submission