Title IX Reporting Form

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Title IX Reporting Form

This form is to notify the College's Title IX Coordinator of an incident or conduct that may be a violation of the College's Title IX/Harassment Free Environment policy. This includes, but is not limited to incidents of sexual harassment or discrimination, sexual assault, domestic or dating violence, or stalking.

You are not required to provide contact information in order to complete this form unless you desire a response. Anonymous reports will be analyzed to the extent possible based on information in the report; however no follow-up will be provided and the College will be limited in its ability to seek clarification and to conduct thorough investigation, if warranted. Any contact information shared on this form will be kept private to the greatest extent possible, but the report is not confidential. Details of the report may be shared with those on a "need-to-know" basis in order to conduct analysis and potential investigation. Please note that if your complaint is against a specific person, that person has a right to be notified of the allegations against them, per Title IX legislation.

NOTE: This is not an emergency service and reports received through this system will not receive an immediate response. Do not use this site to report events presenting an immediate threat to life or property. If you require emergency assistance, call 911. If you need confidential resources related to sexual misconduct, domestic/dating violence, etc. please contact one of our confidential organizational partners:

Laurel House 24/7 Hotline 1-800-642-3150 www.laurel-house.org | @laurelhousepa

Victim Services Center 24/7 Hotline 888-521-0983 www.victimservicescenter.org | @vsmontcopa

I understand that by submitting an anonymous report (or one with incomplete contact information), the College may be limited in its ability to investigate and respond to an incident or conduct. *

Yes, I understand

No, I do not understand, I would rather not complete the form at this time.

Name

Phone Number

What is your affiliation with Reconstructionist Rabbinical College?

Current Student

Former Student

Faculty

Staff

Contractor/Vendor

Lay Leader/Volunteer

No affiliation with RRC

Clear selection

How did you become aware of the incident(s) or conduct?

I experienced it.

I observed or heard it.

I learned about it from another source.

Other:

Clear selection

If other, please explain:

Please describe the incident or conduct, including dates and location, if known. Provide as much information as you know and are comfortable sharing:

Enter the name(s) of persons engaged in the conduct or incident (if known):

Have you accessed any RRC resources (ex. Title IX, VPAA, other senior leader) regarding this conduct or incident?

Yes

Choose not to disclose

Clear selection

Please share any other information you would like for us to know.

Thank You

Thank you for submitting this form. The information will be reviewed by the Title IX Coordinator and maintained by the College. If you have included contact information, someone will contact you soon to discuss next steps.

If the conduct or incident escalates and you require emergency response or additional resources, call 911 or reach out to one of our confidential partner organizations listed above.

For further assistance or questions, contact the Title IX Coordinator :

Cheryl Tyson
Director of HR & Administration, Title IX Coordinator
Reconstructing Judaism & Reconstructionist Rabbinical College
ctyson@reconstructingjudaism.org

215-576-0800 ext 130

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