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Bias Incident Reporting Form


Elon University values and celebrates the diverse backgrounds, cultures, experiences and perspectives of our community members. By encouraging and celebrating these differences, we create an environment that promotes freedom of thought and academic excellence. Elon University denounces bias-related conduct as a violation of University Honor Code. Bias-related incidents, including slurs based on racial or ethnic identity, faith tradition, gender expression/identity, sexual orientation, ability and others create, a hostile educational, living and working environment and such acts are not tolerated in our academic community.

If this is an EMERGENCY situation, CALL 911 or contact the Elon Police Department at 336-278-5555. Do not use this form to report events that present an immediate threat to health or safety. Safeline is a confidential phoneline for Elon community members who have experienced, are experiencing or have questions about identity-based bias, discrimination or harassment as well as sexual violence, relationship violence and stalking: 336-278-3333.

When reporting bias incidents through this form, please also note the following:

1) This process is designed to address concerns raised by Elon University members about actions or biases occurring within the Elon environment or Elon related context. Behavior outside this context falls outside the scope of our response.

2) Your confidentiality and trust is very important to us. We will make every effort to respect your privacy. Please be aware, however, in certain circumstances involving safety or criminal action, we may not be able to guarantee complete anonymity. Regardless of the situations, matters are generally handled discretely and in conformity with University privacy policies, and information about individuals or situations will only be shared with individuals with a legitimate need to know. The University also has strong anti-retaliation policies that protect individuals who report incidents or cooperate in an investigation.

3) We would like anyone reporting an incident through this portal to provide either a phone number or an e-mail address so that we may contact you if there is a need for clarification or if additional questions or concerns arise.

If you have any questions about filing or completing a report, please contact Carla Fullwood, Director of Inclusive Excellence Education and Development at 336-278-5017 or cfullwood@elon.edu.

Background Information

 
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Note: IF YOU ARE CONSIDERED A MANDATED REPORTER, YOU MUST ENTER YOUR NAME IN THIS SECTION.
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Note: IF YOU ARE CONSIDERED A MANDATED REPORTER, YOU MUST ENTER YOUR NAME IN THIS SECTION.
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Involved Parties

Please list the individuals involved (including yourself, if appropriate or if you choose), including any witnesses, as applicable. Please provide as much information as known.

If the name/identity of a person is unknown to you, please enter "Unknown Person" as the name in this section and then describe the individual(s) in as much detail as possible below in your narrative.

Please identity all individuals involved in this incident and their roles.

Potential Roles:

Respondent – Individual who may have engaged in prohibited/harmful conduct

Affected Party – Individual who may have been impacted by the actions of the respondent(s)

Witness – Individual who may have observed the incident but is otherwise uninvolved

Reporter – Individual reporting incident/completing form; uninvolved in incident; did not witness incident

Involved party 1

Questions

This field is required.
NATURE OF THE ALLEGED BIAS: Please check all the categories below that describe the type of bias that occurred/was observed. You will share a description in the narrative section below, including information and reasons you believe the incident was motivated by bias.(Required)
You must make at least one selection.
NATURE OF THE INCIDENT: You can check all types of conduct involved in this incident.
You must make at least one selection.
This field is required.
UNIVERSITY FOLLOW UP: What is your desired outcome/involvement after submitting this form?(Required)
You must make at least one selection.
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.

Submission