Incident Report NameThis field is for validation purposes and should be left unchanged. Attention If you are witnessing a current threat of violence or are concerned for someone's immediate safety, please call 911 and the Louisiana Christian University Department of Safety and Security at 318-308-6505. This form provides Louisiana Christian University employees and students an immediate and accessible option to report discrimination, interpersonal harm, and potential crimes. You may complete this form on behalf of yourself or someone else in the LCU community. This form also provides community members who are associated with the University, but are not employed or enrolled here, to report any concerns or allegations of harm that include Louisiana Christian University employees, students, or property. If you choose to enter your contact information, you will receive a personal e-mail from a resource on campus offering you additional information regarding the rights, options for support, and response options available to you (or to the person(s) involved). That e-mail will also include an invitation to meet in person and review the information that may be relevant and helpful to you, and to help you decide what next steps (if any) will help you meet your goals for reporting. All Louisiana Christian University employees and students have the option and right to report their own experiences anonymously. You should be aware that reporting anonymously limits the response and support the University may offer. Relationship to LCU(Required) Employee Student Community Member First NameOptional. Leave blank if you wish to report anonymously.Last NameOptional. Leave blank if you wish to report anonymously.Email Optional. Provide an email address only if you would like the Title IX Coordinator to contact you.What type of behavior would you like to report?(Required) Gender-Based Discrimination Harassment Dating Violence/Abuse Sexual Assault Stalking Unsure Please describe what you experienced, witnessed, or suspect occurred.(Required)When did this occur?(Required) If you do not know the exact date, please enter your best guess.Where did this take place?(Required) On campus Off campus Unsure Who are the individuals who experienced this?(Required)Who are the individuals who committed this?(Required)Are there any additional details such as names of buildings or names of witnesses that you can share?CAPTCHA