Online Reporting Form for Discrimination, Sexual Misconduct, and Retaliation

This reporting form should be used to report any alleged discrimination, sexual misconduct, or retaliation by or against an ICSW student, faculty employee, or staff employee, including alleged violations of Title IX (acts of sexual misconduct, including sexual discrimination, harassment, non-consensual sexual intercourse and/or contact, exploitation, and interpersonal violence such as stalking, dating violence and/or domestic violence). Please complete all fields honestly and to the best of your knowledge.This form is for reporting acts of sexual misconduct,

ICSW may have an obligation to act on a report even if you do not wish to proceed with a complaint or have action taken. Appropriate ICSW staff will contact you regarding your report.

Name of Person Making Report
Please note: you may report anonymously; however, this will limit ICSW's ability to conduct a Title IX investigation, where applicable.
Which option best describes this form submission?
What is the nature of the alleged misconduct? (please select all that apply)
Do you feel this behavior happened because of your (or the affected party's) membership in any of the following protected classes? (if yes, please select all that apply; if reporting retaliation, please select "retaliation" at end of list)