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Student Behavioral Issue Form

Report a Student Concern or Behavior Issue

Thank you for taking the time to report behavior concerns at Kilgore College. By sharing your observations, you help us maintain a safe, respectful, and supportive campus environment. Your report assists the college in upholding the standards outlined in the Student Code of Conduct and Discipline.

Please do not use this form to report emergencies or situations that present an immediate threat to life or property. Reports submitted through this form may not receive an immediate response. If you need emergency assistance, contact the Kilgore College Police Department at (903) 983-8650 or dial 911.

Report Relationship or Interpersonal Violence, Sexual Misconduct or Discrimination

The Title IX Office to address these concerns and ensure appropriate support and follow-up. To file a report, please use the Title IX Incident Report.

Not Sure How to Categorize a Concern?

If you are unsure whether a behavior violates college policy or don’t know which form to use, please call (903) 988-7486 or email us at conduct@kilgore.edu for guidance.

PLEASE FILL OUT AND SUBMIT THE FORM BELOW

Completed reports will be reviewed by the Dean of Students during normal hours of operation, Monday-Friday. A staff member may contact you to explain the next steps in the conduct process, gather additional information, and/or provide support and resources to you. When completing this form, please include your name, title, and contact information. Please note that anonymously submitted forms may limit our effectiveness in investigating concerning behavior.

Student Behavioral Issue Form

Name(Required)
Email(Required)
MM slash DD slash YYYY
Time of Incident
:

Involved Parties

MM slash DD slash YYYY
MM slash DD slash YYYY
MM slash DD slash YYYY

Description of Incident

Please provide a detailed description of the incident/concern using specific concise, objective language (i.e. factual, unbiased, etc.) to describe the behavior and activities that occurred.

If you have listed an individual as an involved person, they should appear at least once in the narrative. The use of direct quotes, including profanity or abusive language, is encouraged. Please use the person(s) name and avoid using pronouns (i.e. she said, they said, etc...).

These reports are submitted to the Dean of Students or the appropriate designee for resolution.

Which of the Responding Agencies were present for the incident?

Max. file size: 256 MB.
Max. file size: 256 MB.
Max. file size: 256 MB.
Max. file size: 256 MB.