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SBVC - Student Misconduct Incident Reporting Form (Non-Academic)


If there is an immediate risk of harm to self or others prior to submitting this form, call 911. Please contact campus police at (909) 384-4491. Please know that completing this report does not substitute contacting the police.

Referrals from this form will be received during normal business hours (M-F, 8AM - 5 PM) and are not monitored after hours, on weekends, or during official College/SBCCD holidays.

Student Conduct:
Incidents of student misconduct may include issues with alcohol, drugs, disruptive behavior, theft, weapons, violence, harassment, sexual misconduct, or other violations that are non-academically related.

Do NOT use this form to report Academic Dishonesty or Concerning Behavior.

If you would like to report a student for Academic Dishonesty, please click:
File Report

To refer a student who may be struggling with personal, emotional difficulties, or who may be exhibiting concerning behavior, please click:
File Report

Referrals made using "reporting" forms do not violate student privacy rights.

If you have any questions regarding filing an incident report, please contact the Office of Student Life at (909) 384-4474.

Confidential Resources: Reporting to Student Health Services in person will be confidential- Monday through Friday, 8:00am to 4:30pm (spring and fall hours); Monday through Thursday, 8:00am-4:30pm (summer hours). Counselors are available by appointment by calling (909) 384-4495.


Important Phone Numbers:
College Police - (909) 384-4491
Student Health Services (Emotional Crisis Intervention) - (909) 384-4495
Raymond Carlos, Ed.D., Dean of Student Engagement and Wellness - (909) 384-8253
Olivia Rosas, Ed.D., Interim Vice President of Student Services - (909) 384-4473

Reporter Information

Please fill out as much information as you can. We may contact you for clarification or additional information.

 
Email address must be of a valid format.
This field is required.
This field is required.
This field is required.

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 SSN or Drivers License number in the block labeled SID (Student ID #) if available.

Involved party 1

Details of Incident

Please provide a detailed description of the incident using specific, concise, objective language. Include the details of the incident(s) and the behaviors observed. Focus on the Who, What, Why, Where, When, and How. Indicate specific words, phrases, and interactions. If you have listed an individual as an involved person, he or she should appear at least once in the narrative.

This field is required.
Was campus police notified and/or did campus police respond?(Required)
This field is required.
Were any prior actions taken by you?(Required)
You must make at least one selection.
This field is required.
Have you met with the student regarding this incident?(Required)
This field is required.
If Yes, What was the outcome?
You must make at least one selection.
Does your syllabus contain language about Student Conduct?(Required)
This field is required.
Did you inform the student that this incident would be reported to the Student Conduct office (this is recommended)?(Required)
This field is required.
Student Conduct Violation(s)- Check all that apply (please note that these will only be taken into consideration)(Required)
You must make at least one selection.
This field is required.

Supporting Documentation

Photos, video, email, and other supporting documents may be attached below. 5GB maximum total size.
Attachments require time to upload, so please be patient after submitting this form.

Submission