Silent Witness and Title IX Reporting Form

Please complete the form below. Required fields marked with an asterisk *

Please note: In order for the incident to be fully and properly investigated, please provide as many specific details as possible.

Reporting Sexual Harassment

Any person may make a report of sexual harassment regardless of whether the person reporting is the person alleged to be the victim of the reported conduct or not.

Reports may be made in person, by mail, telephone, this online submission form, or email using the contact information provided for the Title IX Coordinator.
Reports can be made at any time, including non-business hours.

Title IX Information

Location of Incident or Crime

Answer Required

Date of Incident

Answer Required

Time of Incident

Answer Required

Description of Incident

Answer Required

If applicable, describe any relevant communication that has already occurred to address this issue. Please be specific with any dates and names of individuals with whom any communication has occurred.

Answer Required

Any other relevant info:

Answer Required

Suspect Name (if known)

Answer Required

Sex

Answer Required

Male

Female

Unknown

Age and/or Grade of Suspect

Answer Required

Approximate Height

Answer Required

Approximate Weight

Answer Required

Race

Answer Required

Hair Color

Answer Required

Eye Color

Answer Required

Other identifying characteristics (clothing, tattoos, piercings, facial hair, etc.)

Answer Required

Vehicle Information (if applicable)

Answer Required

Your Name (if you choose to provide)

Answer Required

I am

Answer Required

Student

Parent

Telesis Staff Member

Other:

Phone (Optional)

Number Required

Email (Optional)

Answer Required

Please fix the highlighted areas below before submitting.

Silent Witness and Title IX Reporting Form

Reporting Sexual Harassment