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Title IX Incident Reporting Form

Background Information

John A. Logan College strongly encourages all good-faith reports, and will respond to all reports based on the nature and quality of the information that is shared. JALC wishes to support you and others affected by the contents of this report. The college understands, however, that there may be reasons why you might choose to withhold your identity or other portions of the narrative now, or indefinitely. Anonymity: You may wish to identify yourself through the fields in this section, or you may elect to remain anonymous. You may choose to identify yourself in the future or not. Be advised that any information included in this report may be shared with the person(s) whose behavior is being reported. If you are uncertain about whether you should include particular names or information about others (e.g. witnesses), please contact the Assistant Provost of Student Affairs at 618-985-2828, Ext. 8386.

If you would like for your report to be confidential you can choose that option from the dropdown menu below.

If you are wanting to submit a report to Campus Police, please use the Safety Review Request Form.

Formal Discrimination and Harassment (Title IX) Incident Reporting Form

Involved Parties

Please list the individuals involved (excluding yourself), including as many of the listed fields as you can provide.

ADD INFORMATION FOR A SECOND INVOLVED PARTY.

Questions

Supporting Documentation

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

Click or drag a file to this area to upload.