MIT Hazing Reporting Form

A hazing incident may be reported to MIT by anyone: a person who was directly affected by the activity, a person who was involved in the incident; staff, parents, friends, or community members; or anyone who is generally concerned about a student or group. If you have witnessed or have knowledge of a possible hazing incident, please report the incident immediately. Our ability to investigate hazing incidents depends on the accuracy and specificity of the information you provide. You are encouraged to provide as much detail as possible so that appropriate action can be taken to address the behavior.

Confidential Reporting: Upon request, the Office of Student Citizenship can keep the identity of the reporting party confidential from the other people involved in the case. This is offered to encourage members of the community to come forward without fear of reprisal. If you opt to make your report confidentially, your identity will remain confidential from people involved in the case; however, you will be contacted confidentially by investigators from the Hazing Investigation Team. Anonymous reports are not accepted due to the inability to confirm or verify the information presented without attribution.

What organization(s) or community group(s) was/were involved in the incident? *

To the best of your knowledge, what types of organizations were involved in the incident (check all that apply)?

What occurred? *

Who were the individuals involved?

Do you know when the incident occurred?

Yes

No

Did the incident occur on multiple dates?

Yes

No

Date of incident: +

Time of incident:

Date of incident: +

Time of incident:

Date of incident: +

Time of incident:

Any additional information about when the incident occurred:

Where did the incident take place?

What led up to this incident?

To your knowledge, has this incident been reported to any law enforcement agency?

Yes

No

Which law enforcement agency has this incident been reported to?

Optional attachment (photos, videos, image of Facebook posts, etc.)

Would you like your identity to remain confidential to the parties involved? If you select yes, your identity will remain confidential from people involved in the case; however, you will be contacted confidentially by investigators from the Hazing Investigation Team. *

Yes

No

Your First Name *

Your Last Name *

Street Address

Address Line 2

City

State

Zip Code

Your Phone Number *

Your Email Address *

This question is for testing whether you are a human visitor and to prevent automated spam submissions. *
captcha

Varsity Athletic Team	Club Athletic Team	Fraternity
Independent Living Group	Band or Other Musical Group	Dorm/Residence Hall
Other/Unknown	On-campus Living Group	Student Organization or Club
Academic Group or Department	ROTC	Sorority