Bias Incident Reporting Form

This reporting form does NOT replace a 911 call or a request for emergency service. Do not use this site to report events that present an immediate threat of life or property. Reports that are submitted through this form may not receive an immediate response. If this is an emergency, please contact Lebanon Valley College Campus Safety at 717-867-6111 or ext. 6111 or dial 911.

If you would like to report a bias incident, you may do so by submitting this form OR by calling the LVC Campus Conduct Hotline Line at 866-943-5787. The LVC Campus Conduct Hotline is a confidential, independent resource that provides the LVC community a simple, anonymous way to alert College officials of a bias incident as well as unsafe or unethical behavior.

Your trust is very important to us and we will make every effort to respect your privacy. However, in certain circumstances, we may not be able to guarantee anonymity.

Full Name (Optional)

Phone Number (Optional)

Email Address (Optional)

Date of Incident (or approx.) *

Time of Incident (or approx.)

Your Role *

I was the target
I witnessed it
Reported to me by another individual
Heard about it after the fact

Please provide as much detailed information as possible to better assist in our investigation and response to the incident. *

Please indicate your interest in being contacted by someone for a follow up. If you provide your name in this report and/or agree to a follow up discussion, the college will make every effort to maintain your anonymity in accordance with your wishes. *

Please contact me. (Don’t forget to provide your contact information above)
Please do not contact me. – I wanted to make a report but do not wish to speak with anyone further about this.

As the college considers your report and determines an appropriate response, your suggestions are welcome. Would you like the college to respond to this incident? If yes, please describe any suggested responses below.

Supporting Documentation

Click or drag a file to this area to upload.

Photos, video, email, and other supporting documents may be attached below.