MGC Incident Complaint Form

Please utilize this form to submit any issues or misconduct that arise during events, calendar conflicts, and/or complaints. Any hazing or sexual assault reports that are submitted will be reported and forwarded to the Student Conduct Office. This form will be referred to the FSL Staff and MGC student leaders. Please note that the form will require your name and email but it will be kept confidential.

This form must be filed within seven business days after the incident has occurred but not more than ten days. It must be factual and not hearsay or rumors. After the incident form has been received, you will be contacted by an MGC student leader for next steps.

Full Name:

Campus Email (wisc.edu):

Organization Affiliation:

I would like to remain confidential.

Yes

Date of Incident:

Location of Incident (if applicable):

Approximate Time of Incident

Name(s) of person(s) involved in the incident and their organization:

Description of incident (Be specific in providing details of time, place, names, description of incident and/or any other information that you may feel may be of value):

Witnesses (include full names and contact details such as respective email addresses and phone numbers if applicable):