BowdoinCollege
Anonymous Report Form for Sexual Assault and Misconduct
What is sexual assault?
The Bowdoin College Sexual Assault and Misconduct Policy defines sexual assault and misconduct in the following ways:
Sexual Assault occurs when the act in intentional and is committed either by a) physical force, violence, threat, or intimidation; b) ignoring the objections of another person; c) causing another’s intoxication or impairment through the use of drugs or alcohol; or d) taking advantage of another person’s incapacitation or impairment, state of intimidation, helplessness, or other inability to consent.
Sexual Misconduct occurs when the act is committed and where, by failing to correctly assess the circumstances, a person believes unreasonably that effective consent was given without having met his/her responsibility to obtain effective consent.
Act referenced in the terms above includes, but is not limited to, sexual intercourse, sodomy, or sexual penetration with an inanimate object, the touching of a person’s intimate parts (defined as genitalia, groin, breast or buttocks, or clothing covering them), or compelling a person to touch his or her own or another person’s intimate parts without effective consent.
Effective consent referenced in the terms above means words or actions that show a voluntary agreement to engage in mutually agreed-upon sexual activity.
Why would I fill out this form?
This information will be used to help enhance understanding of our campus climate so that we may strengthen sexual violence response and prevention efforts, as well as for statistical purposes. Survivors can also use this form to request support.
What happens with this information?
In addition to tracking sexual assaults where Bowdoin students are either the survivors or offenders, Bowdoin may take disciplinary action against the offender and/or the associated group (e.g. club, organization). PLEASE NOTE: Completing this form does not constitute a police report or a student conduct report. You will not be contacted by the College unless you indicate a desire to be contacted on this form.
What if I would like to speak with a person?
To talk to a person about the incident, contact the CounselingCenter at 725-3145, HealthCenter at 725-3236, orthe Office of the Dean of Student Affairs at 725-3149.A counselor-on-call, doctor-on-call and a dean-on-call are available after hours by calling security at 725-3500.
Reporter’s Information (the reporter and survivor can be different people)
Today’s date: ______Reporter’s name (optional): ______
Reporter’s relationship to survivor:______Reporter’s gender: ______
Check here if you are reporting a sexual assault, but you are not the survivor.
Survivor’s Information (the reporter and survivor can be different people)
Survivor’sname (optional):______Survivor’s gender:______Survivor’sage:______
Survivor’s affiliation to BowdoinCollege:
Student Faculty Staff Not affiliated Other: ______
I (the person making this report) would like to be contacted by someone from the following BowdoinCollege offices (please check as many as apply):
HealthCenter
CounselingCenter
Office of the Dean of Student Affairs
Women’s ResourceCenter
Queer-TransResourceCenter
Please contact me using the following phone number and/or e-mail address:
Phone: ______e-mail: ______
Offender(s)’ Information
Note: If an offender(s)’ name or group affiliation is listed, the institution may take action with the offender(s) or group.
Number of offender(s): ______Names of offender(s) (optional): ______
Gender of offender(s ) Male
Female
Multiple Males
Multiple Females
Males and Females
Unknown
Offender(s)’ affiliation to BowdoinCollege:
Student
Faculty
Staff
Not Affiliated
Unknown
Other: ______/ Offender(s)’ relationship to survivor:
Partner, girlfriend, or boyfriend
Friend
Ex-partner, girlfriend, or boyfriend
Faculty, teaching assistants
Staff member
Work supervisor
Colleague or co-worker
Acquaintance
Stranger
Other:______/ Offender(s)’ use of alcohol and other drugs (check all that apply):
Used alcohol
Used drugs other than alcohol
Unknown whether alcohol or
drugs were used
Assault Information
Date of Assault: ______/ Time of Assault: ______Location of assault:(check all that apply)
Survivor’s room
Offender’s room
Workplace
CampusBuilding: ______
Car/Vehicle
Residence Hall
College House
Off-Campus apartment/house
Outdoors
Parking Lot
Other:______
Reported Assault: (check all that apply)
Attempted Sexual Assault/Misconduct
Completed Sexual Assault/Misconduct
( oral vaginal anal) / Was the survivor given alcohol and/or other drug without consent or knowledge?:
Yes, alcohol
Yes, drugs
No
Unknown
If yes, did the survivor feel pressure to consume or use?
Yes
No
Other Reports
To your knowledge, has anyone previously reported this incident to another department or office (for example: Security, HealthCenter, CounselingCenter, Residential Life, etc.) or external agency (for example: hospital, police, etc.)?
Yes No Unknown
If yes, please list department/office or agencies notified: ______
Description of the Incident
If you wish, write a description of the incident and attach it to this form.
Turning in this Form
Please return this form to one of the Anonymous Reporting of Sexual Assault Boxes on campus (located in Moulton Union Second Floor, Women’s ResourceCenter, DudleyCoeHealthCenter, and the CounselingCenter) or mail this form to the following address:
Office of the Dean of Student Affairs
BowdoinCollege
4600 College Station
Brunswick, ME04011
This form can also be found and submitted on-line at