Samueli School of Engineering Anonymous Safety Infraction Reporting

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Information provided in this form will be brought to the attention of the Associate Dean for Research, the department chair, and other relevant people in the Samueli School of Engineering. Higher-level university escalation and due process will happen on a case-by-case basis. You have the option of leaving your contact information -- this will give School leadership the option for followup questions. Thank you for helping us maintain a safe environmental for all.

Any pictures or videos of the infraction(s) can be uploaded here: https://drive.google.com/drive/folders/1L2n0kAs5aw_ICEM3X8DHOyIcv4uK9OcI?usp=sharing

Time and Location of Infraction(s) *

Description of the Infraction(s) *

Person doing the infraction, if known.

Your position: *

Faculty member

Graduate student

Postdoc

Project scientist/other researcher

Staff

Undergraduate student

Do not wish to state

Your contact information (optional)

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