Reporting and Submission Forms
Sexual Misconduct and Sex-based Discrimination
This form is used to provide information necessary to report a concern pursuant to the Sexual Misconduct and Sex-based Discrimination Policy for Students and Employees.
- Questions about this form or the Sexual Misconduct and Sex-based Discrimination Policy should be directed to the Title IX Coordinator
- Sexual Misconduct and Sex-Based Discrimination Reporting Form
Wentworth does not tolerate incidents of bias and discrimination. Bias incidents may take many forms and target an individual or group based on a perceived identity. Individuals who have knowledge of a bias incident on campus or involving a member of the Wentworth community are encouraged to report that information to the Bias Incident Response Team.
- Learn about Reporting Bias Incidents
- Questions about this form should be directed to Peter Fowler
- Bias Incident Reporting Form
General Incident Report Form
Any member of the community can submit a report if they, in good faith, believe that a student’s behavior is in violation of the Student Code of Conduct and/or is adversely impacting the campus community. These reports are viewed by members of the Dean of Students Office.
- Learn about the Student Code of Conduct
- Questions about this form, or the Student Code of Conduct, should be directed to Jenn Kosses
- General Incident Reporting Form
Student of Concern
Any members of the campus community can submit a CARE Report when they are feeling concerned for a student. This may include students who are exhibiting unusual or unhealthy behaviors, significant mood changes, or disruptive behaviors. CARE Reports are not to be used in an emergency. If you have a concern for someone’s safety, call Public Safety at 617-989-4444 or 911 immediately.
- Learn about CARE Reports
- Questions about this form should be directed to Peter Fowler.
- If you are concerned about the health and wellbeing of a faculty or staff member, please contact Meghan Farrington in Human Resources
- Student of Concern Reporting Form
Students who would like to appeal the decision made as a result of their participation in the student conduct process must use complete form. An appeal officer will be assigned to review your documentation as well as review all relevant information associated with this matter. The appeal officer will be in contact with you if they require any additional information.
Student Emergency Fund Request
This form should be used by students who would like to make a request for financial support through the Student Emergency Fund. The Student Emergency Fund assists students with the expenses of life as a college student. The Student Emergency Fund may be used for the purchase of books, supplies for projects, or food, as well as unexpected expenses related to a personal or family emergency.
- Learn about available Financial Hardship Resources
- Questions about the Student Emergency Fund should be directed to the Dean of Students Office
- Student Emergency Fund Request Form
Absence Notification Form
Students who are going to be absent from class for an extended period of time (hospitalization, serious illness or injury, bereavement, jury duty) may submit an absence notification form. The Dean of Students Office will notify your faculty and assist you with your return to campus.
Covid Non-Compliance Form
If you observe others not following the policies and procedures, it is important that you appropriately remind them of their responsibility to promote social solidarity and ensure the health and safety of others. If a member of ou community's non-compliance with policies and guidelines persists, you may report using the COVID non-complaince form.