Montana State University

Sexual Violence Online Reporting Form

This form is available for reporting incidents involving sexual violence allegations that are in violation of the Montana State University Non-Discrimination Policies and the Montana Board of Regents Title IX Policy. Reports can also be filed directly to the Title IX Coordinator at 406-994-5326 or 406-994-2042 or dletendre@montana.edu.

For purposes of reporting, sexual violence means contact of a sexual nature perpetrated against a person's will or where a person is incapable of giving consent due to drugs, alcohol, or disability. Sexual violence includes sexual assault (rape), sexual misconduct and sexual coercion. If you are unsure what constitutes sexual violence, please contact your Title IX Coordinator for assistance.

This report form can be utilized by students wishing to file a report on their own behalf or by anyone wishing to file a report on behalf of the University. All employees--except only those with a legal privilege, such as medical providers, mental health counselors, and rape crisis counselors--are subject to the mandatory reporting obligation and must report allegations of sexual violence to the Title IX Coordinator for your campus.

Do not use this form to report events presenting an immediate threat to life or property. If you require emergency assistance, please contact University Police at 994-2121 or dial 911.

Please provide as much information as possible.

Report Filed By:

Name (first and last name):

Title/Affiliation:

Phone Number: (please include area code. Example: 123-456-7890)

Email Address:

Incident Overview:

What is the nature of this matter?

When did this incident occur (specific or approximate):
Examples: Tuesday, January 24, 2012 @ 3:30
Two weeks ago
Approximately one month ago

People Involved: (Students, University Staff, Faculty) - Please include full name and other identifying information when possible

Were there witnesses of the incident: Please include full name and contact information (if known) when possible.

Incident Description: Please provide as many details regarding the incident, including what you observed, the locations of witnesses and any other information that could be valuable in the investigatory process.

Please indicate other departments that have been notified (optional):

Bozeman City Police Residence Life Staff Member
Bozeman Hospital or Emergency Room MSU Student Health Service
College Dean University Administration
Dean of Students University Employee
Faculty Member MSU Police Department
Off Campus Service (ie. Help Center) VOICE Center
MSU Psychological and Counseling Services   Other:
 

Click here to view the Montana State University Non-Discrimination Policies and Grievance Procedures. Please contact Diane Letendre, MSU Campus Title IX Coordinator with any questions or concerns about filing a report, 406-994-5326 or 406-994-2042 or dletendre@montana.edu.

Confidentiality Statement: The campus is required to take all reasonable steps to investigate and respond to reports of sexual violence while respecting the alleged victim's wishes to the extent possible

Survivors of sexual assault or violence are highly encouraged to contact the VOICE Center:

24-Hour Confidential Support Line - 994-7069
General Office Line - 994-7662
VOICE Center Coordinator - 994-7142
370 Strand Union Building (SUB) (above Leigh Lounge)

Survivors of sexual assault or violence are encouraged to report this incident to law enforcement to pursue criminal charges.

Montana State University Police Department
406-994-2121
Corner of South 7th & Kagy Blvd

City of Bozeman Police Department
406-582-2000
615 South 16th Ave