Discrimination and harassment report

Background Information

Goshen College is committed to protecting the welfare and safety of all community members. Toward this commitment, GC strives to provide an environment free of inappropriate treatment of individuals where students, staff, and faculty can study and work without having to overcome the barriers of discrimination and harassment.

Goshen College does not condone and will not tolerate discrimination or harassment toward any individual based on a person’s race, color, ethnicity/ancestry, national origin, sex, gender identity/expression, religion/creed, disability, age, citizenship status or genetic information.

If you or anyone you know experiences discrimination or harassment, report the incident using this form. The discrimination and harassment response coordinator will receive the report. The coordinator will help you access on-campus or off-campus resources and consider ways to address the situation and prevent it from happening again.

See the Policy & Procedures for discrimination and harassment for more information.

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Your full name:

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If you are not comfortable providing your name, please write Anonymous.

Your position/title:

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Indicate if you are a student, faculty, staff, or not affiliated with Goshen College.

Your phone number:

Your email address:

Email address must be of a valid format.

Nature of this report(Required):

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If you are uncertain about which term fits, choose uncertain and describe the situation below.

Urgency of this report(Required):

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If this is an emergency, please call 911 or Campus Safety (574-535-7599).

Date of incident(Required):

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If you don't have a specific date, select a date close to the event.

Time of incident:

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If you don't have an exact time, select a general time or leave blank.

Location of incident(Required):

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Specific location:

Involved Parties

Please use the search tool to locate the the name(s) of those involved and their role in the incident, such as alleged offender, victim, witness, etc. (See binoculars icon and type first or last name; select correct individual).

In the comments below, please also indicate their role at Goshen College. If you were involved in the incident in some way, please include your name and role as well. If a name is unknown, simply indicate "Unknown" as name.

Name or Organization

Select Gender

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Email address

Questions

Feel free to share whatever information is helpful to you at this time. You may provide additional information when you meet with the discrimination and harassment response coordinator to learn about support, resources, accommodations, and resolution options. Information provided here will remain confidential unless you indicate a potential threat to yourself or others. Please see the Discrimination and Harassment web page for links to the policy, definition, resources, and personnel.

Are you reporting for yourself or someone else? Include additional information below(Required) This field is required.

If you are reporting for someone else, please describe your relationship to the survivor or individual impacted in this incident. This field is required.

Incident description: Feel free to share whatever information is helpful to you at this time.(Required) This field is required.

Please provide any additional information you would like to share. This field is required.

Supporting Documentation

If you have evidence related to the incident (documents, images, videos, screenshots), you may attach them here. 5GB maximum total size.
Attachments require time to upload, so please be patient after submitting this form.

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Background Information

Involved Parties

Questions

Supporting Documentation

Submission