A Student Conduct Incident Report documents potential violations of
University policy. If you
have witnessed an incident which you believe has violated University policy, please fill out
and submit an incident form. You can do this on-line or by contacting the Center for
Student Ethics and Standards, Police Services, or your
To submit an on-line incident report, please fill out the following form completely. We do not accept anonymous
incident reports for student conduct. Once your report is reviewed by the Center for Student Ethics and Standards, we
will contact you to verify its authenticity.
Should you have any questions about this matter or the student conduct process, please contact the
Center for Student Ethics and Standards at 802-656-4360 or stop by our office at Nicholson House,
41 South Prospect Street (next to Waterman).
Documented by (Your First and Last Name):
Your Student ID (95XXXXXXX) Number:
Your Cell Phone Number:
Your UVM Email Address:
Were the UVM Police Involved?
Police Report Number:
Name of Officer:
Time of Incident:
Was Alcohol Involved?
Were Illicit Drugs Involved?
Location of Incident:
University Heights North
University Heights South
Other - On Campus
Names, Addresses, and Phone Numbers of all People Involved in the Incident:
Names, Addresses, and Phone Numbers of all Witnesses (if any):
Narrative: (Please be as detailed and specific as possible.)
If you need additional space, please send in a follow-up email to CSES.
Created/Last revised: August 9, 2012
Author: Sue Pochop
Last modified January 24 2013 02:57 PM