Reporting Form

This form is for all reports of alleged acts of discrimination, harassment and sexual misconduct that would violate the William Woods University Equal Opportunity, Harassment and Nondiscrimination Policy (inclusive of Title IX, ADA and Diversity, Equity and Inclusion concerns).

If you have questions about where to direct other conduct concerns or prefer to give your report or concern in person please contact:

Please fill out the information below to the best of your ability. All information provided will be handled with the utmost privacy and you may be contacted for follow up information.

All reports of discrimination, harassment and sexual misconduct made to William Woods University are taken with seriousness and will be addressed promptly. William Woods strongly encourages all members of the community to report complaints of discrimination, harassment and sexual misconduct. Reporters do not have to be the victim/survivor of the alleged offense in order to file a report. In most cases, University employees are required to disclose reports made to them.

You can make a report without any further participation in any investigation. You do not have to participate in an investigation or press charges to receive medical care, academic, employment, or other campus support. Retaliation against any person for making a report or participating in an investigation is strictly prohibited.

Deliberately false and/or malicious accusations under this policy are a serious offense and will be subject to appropriate disciplinary action. This does not include allegations that are made in good faith but are ultimately shown to be erroneous or do not result in a policy violation determination.

If you feel that your safety or the safety of the Complainant is at risk, please dial 911 or contact Campus Safety at 573.592.4357.

Your Information

First Name* Last Name* Pronouns William Woods Affiliation* (i.e., faculty, staff, student)

Your Role in Incident

Role in Incident* I am a... Complainant (individual who has experienced discrimination, harassment or violence) Respondent (individual accused of discrimination, harassment or violence) Witness or Third-Party Reporter Mandatory Reporter, Other Preferred Phone Number* Is it okay to text this number? * Yes
No Email Address *

Nature of Your Report

Nature of this report (select all that apply) * Title IX Grievance
(Sexual Harassment, Sexual Assault, Domestic or Dating Violence, Stalking, Pregnancy Discrimination)ADA/Section 504 GrievanceCivil Rights Grievance
(Discrimination or Harassment on the basis of age, color, disability, gender expression and identity, genetic information, national origin, race, religion, sex, sexual orientation, or veteran status and all other classifications protected by law)Other If you selected Other, please describe:

Incident Details

Approximate Date of Incident* (month, date, year if known) Approximate Time of Incident Location of Incident* (i.e., on campus, off campus, res hall etc.)

Individuals Involved in Incident

Please list the individuals involved, filling in as many of the listed fields as you can provide.

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Complainant Name: Complainant's William Woods Affiliation (i.e. faculty, staff, student): Phone Number Email Address

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Please identify any individuals who witnessed the incident or have knowledge about the concern with any known contact information.

Incident Description/Concern

Please provide a detailed description of the incident/concern using specific, concise, objective language (who, what, where, when, why and how): Is there anything else you feel is important to share? Do you have any recommendations for Remedies or Resolutions related to the incident/concern?

Supporting Documentation

(You may also wait and provide such documentation at a follow up meeting.)

Please email any photos, videos, emails and other supporting documentation to:
Title IX Coordinator - Michelle.Maupin@williamwoods.edu
Deputy Title IX Coordinator - Tiffany.Nolan@williamwoods.edu

One Last Step

  I assert that the information I have included above is accurate to the best of my knowledge and I understand that someone will follow up with me. * I agree.