Title IX Reporting Form — Iḷisaġvik College

If this is an Emergency, call 911.

Please read this section thoroughly so that you are aware of what resources and reporting options are available to you.

Confidential Resource

If you would like to speak with a confidential resource prior to making this report, call the North Slope Borough Arctic Women in Crisis 907-852-0261 to make an appointment. Counseling is free and confidential for all students and can be held in-person or by phone.

Employees have confidential resources through North Slope Borough Arctic Women in Crisis.

Privacy

Iḷisaġvik College will take every step possible to respect the privacy of those involved. Although the college cannot commit to keeping a complaint of sex or gender-based discrimination confidential because of the college’s obligation to respond to the complaint, the college will use its best efforts not to share information concerning the complaint beyond those that have a need to know.

Thank you for taking this important initial step of reporting, helping Iḷisaġvik College ensure your safety and that of the Iḷisaġvik College community. If you have questions, please contact the Title IX staff via email at titleIX@ilisagvik.edu.

Report Form

Completing this form will start the Title IX complaint process, and the information provided will be referred to the Title IX Staff. Please include concise and detailed facts about the situation. If needed, you can upload additional documentation (ie: emails, photos, police report).

Full Name(Required)
First Last
Status
Phone Number(Required)
Email(Required)
Nature of This Report(Required)
Approximate Date of Incident(Required)
Month
Day
Year
Location of Incident
Specific Location
Involved Parties(Required)
Name or Organization ID# or State Driver's License# Phone Number Preferred Email Address
Please provide as much detail as possible (who, what, where, when), including the name(s) of the victim(s)/survivor(s), the name(s) of the alleged, the names of any witnesses to the incident, and any other information you may have. If needed, clarify the date or location of incident here.(Required)
Were alcohol and/or drugs involved?
Does this incident involve a minor (under 18 years of age)?
Is there any way that we can be of assistance to you? (ie: escorts, housing changes, academic support, counseling services, etc.)
Supporting Documentation
Photos, video, email, and other supporting documents may be attached below. 50 MB maximum total size.
Max. file size: 50 MB.
Review(Required)
- Click the checkbox to confirm that you have reviewed all information before submitting this form.
Phone
This field is for validation purposes and should be left unchanged.

Name or Organization	ID# or State Driver's License#	Phone Number	Preferred Email Address