Reporting Form

TITLE IX REPORTING FORM

Reporting Title IX/ Sexual Misconduct:
Sexual Assault, Dating and Domestic Violence, Stalking, including Discrimination, Harassment, and Retaliation

We take incidents of sexual misconduct and gender and other  discrimination seriously as an institution.  Please know that your concern will be responded to within the time frame listed. This form is used to report incidents of domestic and dating violence, sexual assault, stalking and discrimination or harassment of sex and gender-based concerns.

Looking to report anonymously? Click Here.

• Rockford University Self-Initiated Report

Return Form: Download appropriate form, Print and fill out, scan and send to TitleIXCoordinator@rockford.edu

You also have the option to bring or mail the form to:

Rockford University
Compliance and Title IX Office
Burpee Student Center, Student Life Office
5050 E. State Street
Rockford, IL 61108