<p> Last Modified: 8/19/14 Honor Code Streamlined Report Form For streamlined academic integrity violations and streamlined Title IX Investigations</p><p>Today’s Date: Reporters Name: Investigator’s name (For sexual misconduct and sexual assault reports): Name(s) of aggrieved parties: Name(s) of witnesses spoken to: </p><p>Describe the violation in as much detail as possible, including: Date of violation: Course (if applicable): Building/location (if known): </p><p>Description of violation: </p><p>Decision of responsibility and explanation:</p><p>Recommended sanction and rationale: Include sanction(s) and any conditions. </p><p>Additional information: Include any information pertinent to this violation, such as extenuating circumstances affecting sanction.</p><p>Faculty/Title IX Investigator signature(s) (please print and sign): By signing here I acknowledge that I have consulted the named student about this event, and that, to the best of my knowledge, the description of the violation is accurate, and the suggested sanction is appropriate.</p><p>______Name Signature Date</p><p>______Name Signature Date</p><p>Note: A reporter has the choice to file a report that is criminal in nature (violates a state or federal law) to the Honor Board, Public Safety, or both. For more information, see Section 2 of the Honor Code, "College Jurisdiction,” and Appendix F: Privacy Policies in the Student Handbook.</p><p>Submit this completed form to the Honor Board via email to [email protected], or using intercampus mail addressed to “Honor Board.”</p>