WLU Incident Report FormDate of Incident Month Day YearTime of Incident(ex: 8:00pm)Location of Incident:be specific- building & roomReported by:(name of person completing report)Address of Reporter(building and room number)Email Address of Reporter: Persons Involved:Person Involved: First Last Date of Birth: Month Day YearStudent ID # (including @ symbol)Address:Phone:Person Involved: First Last Date of Birth: Month Day YearStudent ID # (including @ symbol)Address:Phone:Name: First Last Date of Birth: Month Day YearStudent ID # (including @ symbol)Address:Phone:If you have additional persons involved, please include at the end of the description of the incident. Witnesses:Witness: First Last Address:Phone:Witness: First Last Address:Phone:Witness: First Last Address:Phone:If you have additional witnesses, please include at the end of the description of the incident.Type of Incident:--Fire AlarmFYIHealth and Safety InspectionPolicy ViolationViolations: B.1a: Acts of dishonesty, Cheating, plagiarism, or other forms of academic dishonesty. B.1b: Acts of dishonesty, Furnishing false information to any University official, faculty member, or office. B.1c: Acts of dishonesty, Forgery, alteration, or misuse of any University document, record, or instrument of identification. B.2: Disruption or obstruction of teaching, research, administration, disciplinary proceedings, other University activities, including its public service functions on or off campus, or of other authorized non-University activities when the conduct occurs on University premises. B.3: Physical abuse, verbal abuse, threats, intimidation, harassment, coercion, and/or other conduct which threatens or endangers the health or safety of any person. B.4: Attempted or actual theft of and/or damage to property of the University or property of a member of the University community or other personal or public property, on or off campus. B.5: Hazing B.6: Failure to comply with directions of University officials B.7: Unauthorized possession, duplication, or use of keys to any University premises or unauthorized entry to or use of University premises. B.8: Violation of any University policy, rule, or regulation published in hard copy or available electronically on the University website. B.9: Violation of any federal, state, or local law. B.10: Use, possession, manufacturing, or distribution of marijuana, heroin, narcotics, or other controlled substances except as expressly permitted by law. B.11: Use, possession, manufacturing, or distribution of alcoholic beverages (except as expressly permitted by University regulations), or public intoxication. Alcoholic beverages may not, in any circumstance, be used by, possessed by, or distributed to any person under twenty-one (21) years of age. B.12: Illegal or unauthorized possession of firearms, explosives, other weapons, ammunition or dangerous chemicals on University premises or use of any such item, even if legally possessed, not in compliance with BOG Rule 1.9: “Deadly Weapons/Dangerous Objects”. This includes toy guns and replicas of firearms. B.13: Participating in an on-campus or off-campus demonstration, riot or activity that disrupts the normal operations of the University and/or infringes on the privileges of other members of the University community; leading or inciting others to disrupt scheduled and/or normal activities within any campus building or area. B.14: Obstruction of the free flow of pedestrian or vehicular traffic on University premises or at University sponsored or supervised functions. B.15: Conduct that is disorderly, lewd, or indecent; breach of peace; or aiding, abetting, or procuring another person to breach the peace on University premises or at functions sponsored by, or participated in by, the University or members of the academic community. B.16a: Theft or other abuse of computer facilities and resources, Unauthorized entry into a file, to use, read, or change the contents, or for any other purpose. B.16b: Theft or other abuse of computer facilities and resources, Unauthorized transfer of a file. B.16c: Theft or other abuse of computer facilities and resources, Use of another individual’s identification and/or password. B.16d: Theft or other abuse of computer facilities and resources, Use of computing facilities and resources to interfere with the work of another student, faculty member or University Official. B.16e: Theft or other abuse of computer facilities and resources, Use of computing facilities and resources to send obscene or abusive messages. B.16f: Theft or other abuse of computer facilities and resources, Use of computing facilities and resources to interfere with normal operation of the University computing system. B.16g: Theft or other abuse of computer facilities and resources, Use of computing facilities and resources in violation of copyright laws. B.16h: Theft or other abuse of computer facilities and resources, Any violation of the University Computer Use Policy. B.16i: Theft or other abuse of computer facilities and resources, B.16j: Theft or other abuse of computer facilities and resources, Any inappropriate online conduct via online communities. B.17a: Abuse of the judicial process, Failure to obey the notice from a Judicial Board or University official to appear for a meeting or hearing as part of the judicial process. B.17b: Abuse of the judicial process, Falsification, distortion, or misrepresentation of information before a Student Judicial Board. B.17c: Abuse of the judicial process, Disruption or interference with the orderly conduct of a Judicial Board proceeding. B.17d: Abuse of the judicial process, Institution of a Student Code of Conduct proceeding in bad faith. B.17e: Abuse of the judicial process, Attempting to discourage an individual’s proper participation in, or use of, the judicial process. B.17f: Abuse of the judicial process, Attempting to influence the impartiality of a member of a Judicial Board prior to, and/or during the course of, a Judicial Board proceeding. B.17g: Abuse of the judicial process, Harassment (verbal or physical) and/or intimidation of a member of a Judicial Board prior to, during, and/or after a Student Code of Conduct proceeding. B.17h: Abuse of the judicial process, Failure to comply with the sanction(s) imposed under the Student Code. B.17i: Abuse of the judicial process, Influencing or attempting to influence another person to commit an abuse of the judicial process.Additional Violation Information (In this section, expand on any violations of Article III.B.8):Description of Incident:Electronic Signature: Please enter your Student ID Number (including the '@'):Date Completing Report: Month Day YearFileMax. file size: 250 MB.FileMax. file size: 250 MB.FileMax. file size: 250 MB.FileMax. file size: 250 MB.FileMax. file size: 250 MB.NameThis field is for validation purposes and should be left unchanged.