Title IX, Discrimination & Harassment Online Complaint Form

Reporter's Information

If you wish to identify yourself, please fill in the information listed below.

If you are the complainant/victim, you may choose to identify yourself or not. If you are reporting as a third party, provide your contact information here and include the victim's information in the second section titled Involved Parties.

Your full name:

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Please enter the name of the person completing the form.

Your role/title:

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Please enter student, faculty, staff, etc. and your title if applicable.

Your phone number:

Your email address:

Email address must be of a valid format.

Your physical address:

Type of Complaint(Required):

This field is required.

Date of incident(Required):

This field is required.

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If unknown, give an approximate date.

Time of incident:

Location of incident(Required):

This field is required.

Specific location:

Involved Parties

Please identify the person(s) involved in the incident. Enter as much information as you can.

Person or Organization Name

Gender

Role

Hartwick ID Number

DOB (YYYY-MM-DD)

Phone number

Email address

Hall/Physical Address

Questions

Supporting Documentation

Please add any additional documents that support your complaint. 5GB maximum total size.
Attachments require time to upload, so please be patient after submitting this form.

Reporter's Information

Involved Parties

Questions

Supporting Documentation

Submission