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Perry Technical Institute

Campus Incident Report

Please use this form if you are a Perry Technical Institute student, faculty or staff member or visitor wishing to communicate information about an incident of sexual harassment or assault in violation of the Anti-Harassment Policy, the Drug and Alcohol Policy, or the Weapons and Violence Policy to the school on your own behalf or on behalf of another person.

Involved Parties

Please list the names of all faculty, staff, students or other people involved, or who may have witnessed the incident.




Supporting Documentation (optional)

If you have photos, video, email and other supporting documentation, please upload here or email to titleix@perrytech.edu. File upload is limited to 30MB. Please submit larger files and video via email.


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