Please provide your name

Preferred Contact Method:   Please note that unless you provide a contact method, we cannot follow up.


Information about Involved Student (Respondent)


Possible Witness(es) Information

Incident Information

Please note: While anonymous complaints may be received, Western will have limited ability to respond to such complaints.

You will be contacted within 72 hours by a member of the Conduct Office to confirm the form’s information and to review the next steps.