Campus Safety

I want this report submitted to the administrator for Sexual Assault and Harrassment

Yes

I want this report to remain confidential

Yes

Do you want to remain anonymous?

Yes

Full Name *

Your Email *

Your Phone

To the best of your knowledge, when did the incident or incidents occur? Please specifically identify if you are certain of the date(s) and time(s) or if you are providing approximate date(s) and time(s).

To the best of your knowledge, where did the incident or incidents occur?

Please describe the incident(s). Be as specific as possible.

How would you characterize the nature of the incidents?

Was the incident associated with a WTS event or activity?

Yes

Are you the person who experienced the misconduct (the victim)?

Yes

What is your/the complainant's relationship to WTS?

Student

Employee

Parent of Student

Other

Please provide information about the respondent or respondents who were involved in the incident or incidents of sexual misconduct (A “Respondent” is the Person(s) Accused of Engaging in Sexual Misconduct). Provide names, physical descriptions (if names are not known), contact information, or any other information that will help identify the respondent.

Please provide information about anyone who may have witnessed the incident or incidents of sexual misconduct. Provide names, physical descriptions (if names are not known), contact information, or any other information that will help identify the respondent.

What do you hope is the result of you submitting this report?

The information provided in this report is complete and true to the best of my knowledge.

Submit

Campus Safety

Luther Rose Walther Theological Seminary

Luther Rose

Walther Theological Seminary