UNL Sexual Misconduct Incident Reporting Form

Background Information

Enable additional features by logging in.

Your full name:

Your position/title:

Your phone number:

Your email address:

Email address must be of a valid format.

Date of incident(Required):

This field is required.

Time of incident:

Location of incident(Required):

This field is required.

Specific location:

Learn more

If the location is not listed above, but you know the address.

Involved Parties

Please list the individuals involved (excluding yourself), including as many of the listed fields as you can provide. For non-students, please list a diver's license number in the block labeled NU ID number, if available.

Name or Organization

Select Gender

Select Role

NU ID Number

DOB (YYYY-MM-DD)

Phone number

Email address

Hall/Address

Questions

Please provide a detailed description of the incident or concern using specific, concise, objective language (who, what, where, when, why and how).(Required) This field is required.

If there were other people present, what were their names? This field is required.

Was law enforcement involved? Please provide which agency (University Police Department, Lincoln Police Department, Lancaster County Sheriff's Office, etc.), report number and the name of the officer(s) involved, if available.(Required) This field is required.

Supporting Documentation

Please provide any supporting documents here. 5GB maximum total size.
Attachments require time to upload, so please be patient after submitting this form.

Email me a copy of this report

Background Information

Involved Parties

Questions

Supporting Documentation

Submission