Craven Community College

Student Code of Conduct - Incident Report Form


If you have any questions, please contact Denise Carr-Dale via email carr-daled@cravencc.edu or call (252) 638-7401.

Student(s) involved

Name of Student(s) involved, Student ID#, E-mail, and Phone number:
Name:
Student ID Number:
Email
Phone Number
 
Name:
Student ID Number:
Email
Phone Number
 
Name:
Student ID Number:
Email
Phone Number

Incident Information

Incident Information
Date of Incident
Time of Incident
Location of Incident

Witness Information

Witness Information
Name:
Student ID Number:
Email
Phone Number
 
Name:
Student ID Number:
Email
Phone Number
 
Name:
Student ID Number:
Email
Phone Number
 

Additional Notes:

In the space below, describe the incident that occurred and indicate the specific violation. The Code (Standards ofConduct) can also be found in the Student Handbook.

Person reporting the Incident - Contact Information

Name:
Email
Department
Phone Number
 
By entering your name on the line above, you are verifying the student incident information listed is true to the best of your ability.


To avoid a false submission, type into the Text box: and then select the "Submit Form" Button.