Grambling State University
Division of Student Affairs
Office of Student Judicial Affairs

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GSU Box 4309
Grambling, LA. 71245
Telephone: (318) 274-6149/Fax: (318) 274-3297

Anonymous/Confidential Hazing Report Form

Grambling State University Hazing Policy, Code of Student Conduct

In accordance with the purpose and philosophy of the University of Louisiana Systems and the laws of the State of Louisiana, which include the belief that true fellowship can be nurtured only in an atmosphere of social and moral responsibility. Hazing is inconsistent with the responsibility of student organizations to conduct safe, constructive student development programs. Grambling State University is committed to the development of students through academic and extracurricular activities and in keeping with its commitment to a positive academic environment, does hereby unconditionally oppose any situation created intentionally or unintentionally to produce mental, physical, psychological, or emotional discomfort as well as embarrassment, harassment or ridicule.

To send a confidential report, complete the fields below. If you choose to give your contact information, it will
be confidential. Your identity will not be disclosed to the individuals or groups in question.

Incident Details

Organization involved in the incident

Who were the individuals involved?

When did the incident happen? (Date and time)

Where did the incident take place? (i.e. on-campus, off-campus, residence hall, non-residence hall)

What led to this incident?

Description of the incident, please provide as much detail as possible.

Please provide your preferred contact information below. Your identity will be held confidential.
It will not be disclosed to the individuals or group in question. (Optional)

I certify that this information is accurate and truthful