Report Form

Do not use this form to report an immediate threat. If you require emergency assistance, call 911.

Why use this form?

You may use this form to report gender discrimination, sexual harassment, dating violence, domestic violence, sexual assault, sexual exploitation, and stalking under the Policy Against Harassment.

Are there other ways to report?

Yes. You may submit a written report to, or give verbal notice to, the Title IX Coordinator or any Deputy Title IX Coordinator. Such a report may be made at any time (including non-business hours) by using the telephone number, email address, or mailing address listed for the Title IX Coordinator below.

Tanya Jachimiak
Director, Office of Gender Equity and Access
Title IX Coordinator
1200 Academy Street 
Kalamazoo, MI 49006 
Location: Upjohn Library Commons, Office 217 
Phone: 269.337.7480

Can I fill out this form anonymously?

Yes. However, if the College does not have your name, it may be limited in any follow-up.

Who can use this form?

Any Kalamazoo College student, faculty, or staff member.

What happens after I fill out this form?

Information on this form is sent to the Title IX Coordinator for review and follow-up.

Is the information on this form confidential?

No. Students who would like to speak with someone confidentially should contact the Counseling Center, the College Chaplain, or the College Victim Services. Faculty and staff should consult the Employee Assistance Program or other confidential resources.

What if I am a student who violated the alcohol policy?

The College strongly encourages students to report incidents violating the Policy Against Harassment. Therefore, students who act responsibly by reporting to the appropriate authorities information about conduct violating these policies typically will not face College disciplinary action for their own drug or alcohol possession or consumption in connection with the reported incident.

What if someone retaliates against me for reporting?

The College does not tolerate any form of retaliation for reporting in good faith or for participating in an investigation or hearing. This form may be used to report retaliation.