Make Title IX Report | Houston Christian University

Reporting Person Contact Information

Reported By:(Required)

The Victim

A Third Party

If a third party reported the crime to you, please enter the relationship of the third party to the victim:

Name(Required)

First Last

Phone Number(Required)

Email Address:(Required)

Agency Notified

To your knowledge, was a law enforcement notified?(Required)

Yes

Please enter the name of that agency:(Required)

Does the victim want the incident reported to law enforcement?

Yes

Incident Information
Please note that sex offenses, domestic violence, dating violence, and stalking are reportable offenses under Clery Act. The information listed bellow is helpful in determining which incidents are reportable under both the Clery Act and Title IX.

Name of the person who experienced sexual violence?

( If known)

First Last

Location of incident

Building Name Street Address/Office Number City State / Province / Region ZIP / Postal Code

Date of Incident(Required)

Time of Incident

(If known)

Incident Description(Required)

(Please provide specific, detailed information)

If you have any additional attachments, please upload here:

Max. file size: 100 MB.

Name of Alleged Perpetrator

(If known)

First Last

Other Student(s) Involved in the Incident:

Location

What best describes the location of the incident?(Required)

( If the incident occurred in multiple places, check all that apply.)

On Campus, residence hall

On Campus, not in a residence hall

Public property immediately adjacent to cmapus

Non-campus in a University owned leased or controlled space ( fraternity, sorority, off-campus classroom)

Unknown location, other

I do not know which category this would fall under

Geography Definition: On campus
Any building or property owned or controlled by an institution within the same reasonably contiguous geographic area and used by the institution in direct support of, or in a manner related to, the institution’s educational purposes, including residence halls; and
Any building or property that is within or reasonably contiguous to the area identified in paragraph (1) of this definition, that is owned by the institution but controlled by another person, is frequently used by students, and supports institutional purposes (such as food or other retail vendors)

Geography Definition: Public Property
All public property, including thoroughfares, streets, sidewalks, and parking facilities, that is within the campus, or immediately adjacent to and accessible from the campus.

Geography Definition: Non-campus building or property
Any building or property owned or controlled by a student organization that is officially recognized by the institution; or
Any building or property owned or controlled by an institution that is used in direct support of, or in relation to, the institution’s educational purposes, is frequently used by students, and is not within the same reasonably contiguous geographic area of the institution

Please Describe Location to the Best of your Abilities:(Required)

Please Review the information within the form, and submit when completed.

Title IX Reporting Form