If you have witnessed or experienced sexual misconduct, please complete the form below. Once submitted, the form will be received by Michael Bicking, the Director of Public Safety at Eastern University. Additionally, the report will be submitted to the Student Development Office for further follow up and/or investigation.

See a list of Eastern's Title IX Officer/Deputies and learn more about the Title IX Policies here.

* = REQUIRED INFORMATION

Crime Classification

Please indicate one of the following:
(If you do not know which to choose, please select "Not Listed Above" and provide details
below.)
Sex Offenses, Forcible
Sex Offenses, Non-Forcible
Homicide
Assault
Robbery/Theft/Property Damage
Law Violations
Burglary
Location:
Date and Time of Offense:
dd/mm/yyyy, mm/yyyy or semester/yyyy
e.g. - 9:00 am, 6:15 pm
Date and Time Incident was Reported To You:
dd/mm/yyyy, mm/yyyy or semester/yyyy
e.g. - 9:00 am, 6:15 pm
Perpetrator:

Optional Information

Contact Information

Please Note: If you choose to remain anonymous, it may limit the University's ability to thoroughly investigate this report.

**Anyone who is a Public Safety Officer is required to submit their name.

Hate Crime

If the victim/survivor was intentionally selected because of actual or perceived race, gender, gender identity, religion, sexual orientation, ethnicity, national origin or disability, please indicate the category of prejudice:

Please Select One Or More
(This information is not required.)
Please provide additional details regarding the events described in this report.
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