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.
Directions for completing the Adobe fillable form:
**If you receive a message stating the PDF cannot be read, select Open With Different Viewer from upper right part of the website.
- Select and save file as: Title IX Reporting Form from a computer (form may not open with all mobile devices.
- After completing the form, use the purple submit form button located at the top of the page and follow the prompts to submit your form by email.
Return Form: Save completed form, scan and send to TitleIXCoordinator@rockford.edu
You also have the option to bring or mail the form to:
Compliance and Title IX Office
5050 E. State Street
Rockford, IL 61108