Title IX Incident Reporting Form

NTCC Provides Opportunities students and employees to file a complaint against the college, students, employees or
a third party (auxiliary organizations, independent contractors at the campus, campus vendors and their employees or campus visitors). This form should only be used by students to submit Title IX complaints. All employee, college and third party complaints should be submitted directly to the Human Resources Department (christibrown@northshorecollege.edu).

When you submit this form, the owner will see your name and email address.

Name Name First Last
LoLA Number
Location where the incident occurred
Date and Time of the Incident
Please Provide the name of the Respondent (the accused party)
Please provide contact information for the respondent (if possible)
Incident Description: - Please be as specific as possible, identify date, any witnesses, detailed description of factual events (sexual harassment, sexual violence, power based violence, discrimination, retaliation) leading to complaint and the specific harm resulting from event/events.
Please describe any additional relevant information
Use the link below to upload all relevant files or documents

Attach Files