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Sexual and Gender-Based Harassment and Misconduct Reporting Form


This form should be used to report any incident involving an alleged violation of the Lincoln University Title IX Policy concerning sexual and gender-based harassment and misconduct.  Sexual and Gender-Based Harassment and MIsconduct includes sexual and gender-based harassment, sexual assault, interpersonal/dating violence, stalking, and other forms of sexual and gender-based misconduct or discrimination.

Please note that submissions using this form may not be reviewed outside of normal business hours.  If there is an immediate risk to health or safety, please call 911 or contact LUPD at (573) 681-5555.

Lincoln University takes incidents of sexual and gender-based harassment and misconduct seriously and is required to investigate allegations to the best of its ability. By submitting this report, you are stating that all information contained in the report is true and correct to the best of your knowledge. Knowingly providing false information may result in disciplinary action.  The University prohibits retaliation for making a good faith report of sexual or gender-based harassment or misconduct. Retaliation should be reported immediately to the Office of Title IX.

All faculty and staff, with the exception of those in Thompkins Health Center, are obligated to report information to the Office of Title IX (573) 681-5003 or titleix@lincolnu.edu if they receive notice of an incident of sexual or gender-based harassment or misconduct. Responsible employees must not submit this form anonymously. Student reporters or reporting parties may remain anonymous; however, the University may be limited in its ability to respond to anonymous reports where the identity of those involved is unknown.

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Your Information

If you wish to fill this fom out anonymously, do not provide any identifiable information including:

  • Your Name
  • Position/Title
  • Phone Number
  • Email Address
  • Local Addreess

You may type in "Anonymous" into the "Full Name" field to make it clear this is anonymous and provide your general relationship with LU (i.e. Student/Non-RA, Student/RA, Faculty, Staff, Community Member, or LUPD).

If you are the victim/complainant, please add your information in the "Involved Parties" section as well.

 
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i.e. Student/Non-RA, Student/RA, Faculty, Staff, Community Member, LUPD
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Involved Parties

In the following section, please provide information regarding the individuals involved in the incident. Please identify involved parties based on the following roles:

  • Reporting party: any person(s) who may have been subjected to harassment or misconduct. This includes individuals who were not present during the incident but received information regarding the incident from those who were involved.
  • Responding party: any person(s) or organization accused of causing harm.
  • Witness: any person(s) who may have directly observed an incident or have direct or indirect knowledge related to an incident of harassment or misconduct.
Involved party 1

Questions

This field is required.
To your knowledge, was this incident reported to a police or law enforcement agency (check all that apply).(Required)
You must make at least one selection.
Have any other departments been notified (check all that apply)?(Required)
You must make at least one selection.
This field is required.
Does the victim want someone from the Title IX Office to contact them for resources and assistance?(Required)
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Supporting Documentation

Photos, videos, email, and other supporting documents may be attached below. 5GB maximum total size.
Attachments require time to upload, so please be patient after submitting this form.

Submission