Hazing Report Form
     
  Your Name:

(optional, your information will be kept confidential)

  Your Phone Number:

(optional, your information will be kept confidential)

  Your E-mail Address:

(optional, your information will be kept confidential)

     
Organization in Question (required)
  If you selected Other, please specify:
   
     
Date of the Incident (if known)
Time of the Incident (approximate)
     
Your Description:  
  Active Member of the Fraternity/Sorority in question
Active Member of another Fraternity/Sorority
Parent of an Active Member of the Fraternity/Sorority in question
New Member/Pledge of Fraternity/Sorority in question
New Member/Pledge of another Fraternity/Sorority
Parent of a New Member/Pledge of the Fraternity/Sorority in question
Parent of a Member of the Fraternity/Sorority in question
Drury Faculty/Staff
Drury Student
Springfield Community Resident
Other (please specify)
     
Description of the Incident:

(please provide as much detail as possible, including location, number of people involved, names of people involved, type of activity, etc.)