Anonymous Reporting Form
You can use this page to submit reports of sexual assault, dating/domestic violence, or stalking activity anywhere on or near the campus of Bennett College. Only enter your name, email and telephone number if you wish to be contacted. This form allows you to report any known incidents to the Campus Safety while remaining anonymous.
If you would like to speak privately to a SART advocate now, please call (336) 365 - 6879. Advocates are on call 24/7 and can provide information, support, and resources.
NOTE: Information included in this form goes privately to Campus Safety. No further action will be taken after receiving this form unless requested.
September 3, 2018
Nature of the Incident
Non-consensual Sexual Contact
Damage to Property
Location of the Incident
I have spoken with a confidential resource about the situation
This information is not required.
Watkins House / Bennett College
Victim's Date of Birth
Reporting Person's Name
Affliation to victim
If witness present, please present all information available.
Witness First and Last Name
Witness Phone Number
Witness Email Address
Page 1 of 2
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.
Terms of Service