Office of Diversity Online Incident Report Form

Include the following details about the incident

Please note: The intended use of this form is to report incidences of microaggression, bias, and racism at WCUCOM. Submitted forms will be sent directly to the WCUCOM Director of Diversity. All forms will be reported to the WCU Vice-President for Student Affairs.
Date of Incident: Date of Incident: / MM / DD YYYY
Time of Incident: Time of Incident: : HH MM AM/PM
Location of Incident (class, event, etc.)
Name of Offender(s):
Description of the Incident: