Community Standards Violation

Background Information

Your full name:

Your position/title:

Your phone number:

Your email address:

Email address must be of a valid format.

Your physical address:

Nature of this report(Required):

This field is required.

Urgency of this report(Required):

This field is required.

Date of incident(Required):

This field is required.

Time of incident:

Location of incident(Required):

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Specific location:

Involved Parties

Please list the individuals involved (excluding yourself), including as many of the listed fields as you can provide. For non-students, please list an SSN or Drivers License number in the block labeled SID if available.

Student Name

Select Gender

Select Role

Student ID Number

DOB (YYYY-MM-DD)

Phone number

Email address

Hall/Address

Questions

Below are categories that correspond to a Community Standards violation.

In ALL cases of emergency please report to the Office of Public Safety at 610.796.8350

COMMUNITY STANDARDS VIOLATION

Community Standards Violation

You must make at least one selection.

CSA REPORT

CSA Report

You must make at least one selection.

Please provide a detailed description of the incident/concern using specific concise, objective language. This field is required.

Supporting Documentation

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

Email me a copy of this report

Background Information

Involved Parties

Questions

Supporting Documentation

Submission