Refer a Matter to the Office of Student Rights and Responsibilities

Employees of the university have the responsibility to support the policies, rules and regulations of PLU. Students, as members of the community, have the right to address issues that may be incongruent with university policies, rules and regulations. Therefore, when a student’s conduct appears to be in violation of university policies, rules or regulations, any student, staff, or faculty member may submit an incident report.

If you are unsure whether the incident should be referred to the Student Rights and Responsibilities System, contact the Student Rights & Responsibilities (SRR) office.


Following these instructions to complete an incident report:

  1. Please be specific and objective when completing each portion of the report.
  2. Include the date and time of the incident to the best of your knowledge.
  3. Include the location of the incident.
  4. Include the student’s name, identification number, address (if known), and phone number (if known)
  5. Place a mark next to the violation(s) in question (if unsure, contact SRR office)
  6. List any witnesses who have knowledge of the incident. Include addresses (if known) and phone numbers (if known) for witnesses.
  7. Provide a Summary of Facts. This portion should be written as clearly as possible (in complicated incidents, writing in the third person is helpful). Please provide the following information to the best of your knowledge. If something is unknown (i.e., the name of someone involved), please provide as much information as possible (i.e., “There were two more females in the room who may have been PLU students, but I was unable to get their names”). Please do not include subjective details. Instead of writing, “He was angry.” Please give more objective details and write, “He used a loud voice and stomped away.” Please do not include unrelated details or hearsay (i.e., “My friend said that she lies all the time.”) Be sure to include information about the following:
    • How you became aware of the situation
    • Who is involved in the situation—include names of all people present (to the best of your knowledge)
    • What you saw, heard, smelled, etc. that led you to believe that a violation of policy was taking place or had taken place—include objective details such as quantity, speed, language, types of alcohol, etc.
    • Summary of your communication with the student in question (if applicable)
    • Who was contacted for assistance (i.e., Campus Safety, Resident Assistant)
    • Outcome of the incident—how it was resolved at the moment
    • Write your name, signature and date at the bottom of the form.


Please forward all questions and comments to:

Last Modified: February 11, 2015 at 10:55 pm