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Report an Incident

Please provide detailed information regarding the incident or situation you are reporting involving a Bergen Community College student.

For emergency situations please contact the Office of Public Safety at 201-447-9200 or by dialing "6" on any campus phone.
Reports filed through this online Incident Report are immediately received through the system and reviewed the next business day.
This form is to be used to report incidents of general misconduct, care and concern for a student, and policy violations. To file a complaint, visit www.bergen.edu/studentcomplaint. For reports involving Bergen Community College staff or faculty members, please contact the Office of Human Resources at 201-447-7442 or humanresourcesgroup@bergen.edu.

Specific charges are intentionally not included on this form. Please make any recommendations regarding specific conduct charges, if applicable, within the body of the report.
Bergen Community College highly discourages anonymous reports about students. Unless you include your contact information and submit this form, Bergen Community College may be limited in its ability to investigate the report or respond back to you regarding the subject matter. Once the report is received, a college staff member will review the report, and where necessary investigate the incident and determine appropriate intervention/action plan for the student’s behavior, which may include a meeting with the student and others involved in the incident. Please know that you, and the witnesses you identify in the report, may be contacted to provide further information.

With regard to reports of alleged Student Code of Conduct violations, student conduct records are protected by a federal privacy law called the Family Educational Rights and Privacy Act, therefore any information regarding the outcome of this report will not be shared with you without the direct consent of the student(s) involved.

If you have any questions regarding filing an Incident Report, please contact the Office of Student Life & Student Conduct at 201-447-7215 or email studentconduct@bergen.edu.

Background Information

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Your full name:

Your position/title:

Your phone number:

Your email address:

Email address must be of a valid format.

Your physical address:

Nature of this report(Required):

This field is required.

Urgency of this report(Required):

This field is required.

Date of incident(Required):

This field is required.

Time of incident:

Location of incident(Required):

This field is required.

Specific location:

Involved Parties

Please tell us who was involved in this incident.

Name

Select Gender

Select Role

ID Number

DOB (YYYY-MM-DD)

Phone number

Email address

Address

Questions

Please select the alleged violations(Required)

Disruptive behavior - Classroom

Disruptive behavior - Non-classroom

Verbal altercation

COVID-related

Theft

Sexual Misconduct

Other (please describe below)

You must make at least one selection.

Please provide a detailed description of the incident/concern using specific concise, objective language (Who, what, where, when, why, and how).(Required) This field is required.

If Public Safety was involved, please identify the officer(s) who responded to the incident. This field is required.

Supporting Documentation

You may upload any supporting documentation, photo or video to this incident report. 5GB maximum total size.
Attachments require time to upload, so please be patient after submitting this form.

Email me a copy of this report