Online Report Form

This form is designed to provide students, staff, faculty, applicants, visitors, or others with an on-line method to report specific information related to an alleged incident(s) of discrimination, harassment (including sexual misconduct), or retaliation.

Regardless of whether a report results in a full investigation and adjudication under PPM 3010, the college helps reported victims of prohibited conduct by providing support and assistance services. These support and assistance services are intended to help a reported victim continue to access the working and learning environment at Salina Tech. Support and assistance services are also available to respondents.

You may file a complaint with the Vice President of Student Services in person, by regular mail, or by email. Generally, the VP of Student Services will need all of the information below. You may (but are not required to) print this form and bring it to the office in person, mail the form to the VP of Student Services, or submit it by email. To discuss your complaint with a member of the Title IX team, you can schedule a meeting in person, via telephone, or email at the contact information provided once you submit the form online.

Confidentiality: Complaints are confidential and will not be disclosed to anyone who does not have a need to know. This requirement applies to complainants, respondents, witnesses, and any others involved with a complaint. If you believe criminal conduct has occurred, then you should make a criminal complaint to the police. The criminal justice system and this Policy are separate procedures; however, reports must be made under both procedures to ensure that both will go forward.

Reporter's Information


Involved Parties

Please list all persons involved. This includes the respondent and any witnesses to the incident. Definition of Roles: Complainant: is the person affected by the prohibited conduct. Respondent(s): is the person whom the complaint is about or the person who is believed to have caused the prohibited conduct. Witness(es): is any person with direct or indirect knowledge of the allegation(s) of prohibited conduct made in a complaint or report.



The discrimination impacted the follow: (please select all that apply) *
I certify the information provided is true and accurate to the best of my knowledge. *
I understand that submitting this report constitutes official notice to Salina Tech and authorizes the institution to evaluate this concern pursuant to College Policy. *
Do you wish to request a reasonable accommodation of a disability in order to participate in the reporting and/or resolution process? *

Supporting Documentation