Anonymous report (Penryn, Falmouth and Truro Campuses)

This form is anonymous and confidential. It is for students and staff from the University of Exeter, Falmouth University, FX Plus and The Students’ Union to use.

We will not be able to act on the information or respond to you in person but please read below how your information will be used.

If you would like a response

Please use the confidential informal reporting form instead of this one, so a member of staff can get in touch with you.
Students can access Student Services for more information and other sources of support

How we will use your information

It is not possible to identify any individuals from the data collected in this form.
The Universities will use the information you provide to help us understand what kind of incidents are taking place within our communities and take positive action.
Anonymised reports on the data collected will be considered by the Universities’ senior management and relevant multi-institutional working groups , and published annually online and shared with external agencies (such as Devon and Cornwall Police) to enable a community-based approach to tackling hate incidents and crimes.

Please tick the box to confirm you have read the information above. All other questions are optional.
I have read the information above and understand that no specific action can be taken as a result of reporting anonymously. *

About you
Please select your institution:
Who are you reporting on behalf of?
And you are a:
What is your level of study?
What is your fee status?
Why would you prefer to report anonymously? (Please tick all that apply)	I don't know the individuals involved I don't feel authorised to share details of the individuals involved I'm not sure if it's serious enough to report formally I don't want to get involved in a formal process I want to move on quickly and not re-live the incident for any longer than necessary I don't trust that the University will take appropriate action I am concerned my experience at the University will be affected as a result I am concerned my personal life will be affected as a result Other Prefer not to say

About the incident(s)
Which institution(s) does the incident involve? Individuals from (please select all that apply):	University of Exeter Falmouth University FX Plus (manages and delivers shared services for both Universities, including accommodation, catering and Student Services) The Students' Union The local community (members of the public) Other
When did the incident(s) take place? ?	It's ongoing In the last week In the last month In the last year Between 1-5 years ago Over 5 years ago If there has been more than one event please use the most recent date.
Where did the incident take place?
Which campus?
What type of space was it?	Teaching space Admin space Office space Social space University accommodation None of these Prefer not to say
Which city?
What type of location?	Fieldwork Placement Studying abroad Other Prefer not to say
What mode of transport?
Was the incident connected with a specific College, service or society?
University of Exeter:
Falmouth University:
Campus Services:
The Student’s Union

What was the behaviour experienced? (Please tick all that apply. Click the question marks for definitions)
Harassment ?	Bullying Online Physical Racist behaviour Sexual Stalking (in person or online) Verbal Other harassment Unwanted conduct on the basis of a protected characteristic which has the purpose or effect of violating an individual's dignity or creating an intimidating, hostile, degrading, humiliating or offensive environment for that individual.
Direct and indirect discrimination ?	Less favourable treatment regarding social activities Less favourable treatment regarding teaching and education Less favourable treatment regarding access to employment opportunities Other discrimination Being treated less favourably than someone else because of a protected characteristic, or because you associate with someone who has a protected characteristic, or where there is a rule in place which disadvantages people with a protected characteristic.
Violence and abuse ?	Controlling or coercive behaviour Domestic violence or abuse Hate crime Intimidating behaviour Physical misconduct (hitting, pushing, spitting) Sexual violence or abuse Other violence or abuse The intentional use of power or physical force, threatened or actual, against oneself, another person, or against a group or community, that either results in or has a high likelihood of resulting in injury, death, psychological harm, maldevelopment, or deprivation.
I don't know
Prefer not to say

What do you think was the reason for this incident? (Please tick all that apply)
My / the target's:	Age Disability (including hidden disabilities and mental health) Gender reassignment/transgender Marriage or civil partnership Pregnancy or maternity leave Race (including colour, nationality, ethnic or national origin) Religion, belief or lack of religion/belief Sex Sexual orientation I don't know None of these

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