1 Start 2 Complete Objectives of Incident Report The main objective of the the incident report is to allow FSCC and its community members to ensure, through open communication, that FSCC’s codes of conduct are protecting members of the campus community from harm due to the indiscretion of those on campus who are unable or unwilling to respect the rights of others and/or have violated college rules and regulations as listed in the Student Handbook. Misconduct is considered a matter of concern to administrators, faculty, staff and students alike. Reports of misconduct are usually made to the Vice President of Student Affairs for investigation and determination of appropriate action. Process of Reporting If a person is an immediate threat to themselves or someone else or is incapable of caring for themselves, CALL 911. Any individual may make an anonymous report concerning an act of sexual misconduct and/or individuals who have violated college rules and regulations as listed in the Student Handbook. An individual may report the incident without disclosing his or her name, identifying the respondent or requesting any action. Depending on the level of information available about the incident or the individuals involved, the college’s ability to respond to an anonymous report may be limited, however, this is a form that allows anyone to report suspected misconduct or other issues with complete confidentiality. This service allows the person making the report and college administrators to confer about additional details, while the reporting party's identity remains confidential. All reports will go to the Vice President of Student Affairs. Background InformationFields that don't have a red asterisk next to them are not required. Nature of this report * - Select -General Conduct ReportResidence Life ReportConcerning and Threatening BehaviorAcademic IntegrityInformationStudent Life ActivitySecurity Urgency of this report - None -NormalCritical Date of incident * Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 Year Year20212022202320242025 Time of incident Hour Hour123456789101112 : Minute Minute000102030405060708091011121314151617181920212223242526272829303132333435363738394041424344454647484950515253545556575859 am pm Specific location Reasons for Report Aberrant Behavior Bizarre behavior Depressed/displays persistent sadness/unexplained crying Displays anger/negative emotions inappropriately Disturbing written material/class discussion Engages in disruptive classroom behavior Excessive anxiety Extreme mood swings Informational - athletics Informational - family issues Informational - housing/roommate concerns Informational - medical Informational - other Obsessively suspicious/mistrustful Other concerning behavior Possible missing student Significant change in appearance/behaviors Suicidal tendencies/self-injurious behavior Threatens or engages in violent behavior (written/verbal) Unusual bruises, cuts, abrasions, or scrapes College Academic Integrity - Cheating Academic Integrity - Dishonesty Academic Integrity - Fabrication Academic Integrity - Plagiarism Academic Integrity - Unauthorized Access Alcohol Arson Assault Bullying Cafeteria Violation Classroom/Educational Disruption Controlled Substances Dating and Domestic Violence Discrimination Failure to Comply Fighting/Mutual Combat Fire Harassment Hate Crime Inducing Incapacitation Motor Vehicle Theft Murder No Incidents Prohibited Sexual Misconduct Retaliation Sex Offense Sexual Assault Social Media Violation Solicitation Stalking Student Life Activity Report Substance Abuse Theft Trespass Unauthorized use/possession of keys Vandalism/Damage to Property Weapons Community Community Disturbance Off-Campus Housing Concern Housing Residence Hall Violation For more information on Residence Hall Violations, see the Dorm Handbook. Involved PartiesPlease list the individuals involved (excluding yourself). If there are more than 3 people you'd like to provide information about, please also use the Additional People box. For non-students, please list a SSN or Drivers License number in the block labeled SID (Student ID #) if available.Person 1 Name or organization Gender - None -MaleFemaleOrganization Role - None -AllegedVictimWitnessStudent of concern ID number Date of birth Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 Year Year19231924192519261927192819291930193119321933193419351936193719381939194019411942194319441945194619471948194919501951195219531954195519561957195819591960196119621963196419651966196719681969197019711972197319741975197619771978197919801981198219831984198519861987198819891990199119921993199419951996199719981999200020012002200320042005200620072008200920102011201220132014201520162017201820192020202120222023 Phone number Email address Hall / Address Person 2 Name or organization Gender - None -MaleFemaleOrganization Role - None -AllegedVictimWitnessStudent of concern ID number Date of birth Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 Year Year19231924192519261927192819291930193119321933193419351936193719381939194019411942194319441945194619471948194919501951195219531954195519561957195819591960196119621963196419651966196719681969197019711972197319741975197619771978197919801981198219831984198519861987198819891990199119921993199419951996199719981999200020012002200320042005200620072008200920102011201220132014201520162017201820192020202120222023 Phone number Email address Hall / Address Person 3 Name or organization Gender - None -MaleFemaleOrganization Role - None -AllegedVictimWitnessStudent of concern ID number Date of birth Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 Year Year19231924192519261927192819291930193119321933193419351936193719381939194019411942194319441945194619471948194919501951195219531954195519561957195819591960196119621963196419651966196719681969197019711972197319741975197619771978197919801981198219831984198519861987198819891990199119921993199419951996199719981999200020012002200320042005200620072008200920102011201220132014201520162017201820192020202120222023 Phone number Email address Hall / Address Additional PeoplePlease feel free to add any additional information in the box below. Additional People Text Description / NarrativePlease provide a detailed description of the incident/concern using specific concise, objective language (Who, what, where, when, why, and how). Description Text Additional Questions Did police respond? * Yes No Did fire respond? Yes No Did EMS respond? Yes No How would you prefer to receive follow-up? * - Select -PhoneEmailDo not contact me Optional InformationAn individual may report the incident without disclosing his or her name, identifying the respondent or requesting any action. Depending on the level of information available about the incident or the individuals involved, the college’s ability to respond to an anonymous report may be limited, however, this is a form that allows anyone to report suspected misconduct or other issues with complete confidentiality. This service allows the person making the report and college administrators to confer about additional details, while the reporting party's identity remains confidential. All reports will go to the Vice President of Student Affairs. Your full name Your position/title Your phone number Your email address Your physical address Supporting DocumentationPhotos, video, email, and other supporting documents may be attached below. Maximum 8 megabytes per file Attachments require time to upload, so please be patient after you click to submit this report. If your document is larger than 8 megabytes, please send it to the Office of the Vice President of Student Affairs. Supporting File Files must be less than 8 MB.Allowed file types: gif jpg jpeg png avi mov mp3 ogg wav. In addition to utilizing the statutorily created political subdivisions of the state complaint process: Consumer protection and/or fraud complaints may be filed with the Kansas Attorney General's office. Discrimination complaints may be filed with the Kansas Human Rights Commission. Complaints regarding State Authorization Reciprocity Agreement (SARA) courses delivered by SARA member community colleges may be filed by students enrolled in those courses with the Kansas Board of Regents office. Kansas Community Colleges are regionally accredited by the North Central Association of the Higher Learning Commission on Colleges and Universities (NCAHLC). Complaints regarding an institution's ongoing ability to meet the Criteria of Accreditation may be filed by following the guidelines at https://www.hlcommission.org/HLC-Institutions/complaints.html. CAPTCHAThis question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
