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Title IX

Title IX Reporting Forms

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Title IX Reporting

If you are in need of immediate assistance, please find a safe place and call Campus Safety and Security at 304.830.3924 or 911.

The college’s Title IX Coordinator oversees compliance with all aspects of the College’s sex-based harassment and discrimination policy. The Coordinator reports directly to the Vice President of Student Life, and is housed in the Office of Student Life.

Anyone wishing to make a report relating to discrimination or harassment may do so by reporting the concern to the College’s Title IX Coordinator:

Khali M. Carpenter, Esq.
Associate Vice President of Student Life
Office Location: Bethany House
Phone: 304.829.7064
Email: KCarpenter@bethanywv.edu or titleix@bethanywv.edu

Individuals may report multiple ways. Reports can be made in person to the Title IX Coordinator. Individuals can also report to any on-campus employee, as all Bethany College employees are mandated reporters (excluding any employees identified as Confidential Reporters). Online reporting is available under the Reporting Forms section at the bottom of this webpage.

In addition, individuals experiencing harassment or discrimination also always have the right to file a formal grievance with government authorities:

Office for Civil Rights (OCR)
Philadelphia Office
U.S. Department of Education
The Wanamaker Building
100 Penn Square East
Suite 515
Philadelphia, PA 19107-3323
215.656.8541
E-Mail: OCR@ed.gov
www.ed.gov/ocr

Title IX Reporting Forms

File a Report

File a Report

  • This field is for validation purposes and should be left unchanged.
  • I wish to report possible discrimination/harassment in violation of Bethany College's Nondiscrimination and Anti-harassment Policy based upon:
  • Against whom are you filing this report? Please list the name(s) of the individual(s) you believe violated the policy. For each name, write the person's status (i.e., student, faculty, staff, campus visitor), if known.
  • When did the incident(s) occur? Be as specific as possible.
  • Please describe the incident(s). Be as specific as possible about what happened, including information about the people involved.
  • Were there any witnesses to the incident(s)? Please list the name(s) of the individual(s) you believe may have information that is relevant to the investigation. For each name, please write the person's status (i.e., student, faculty, staff, campus visitor), if known.
  • What action/remedy are you seeking? Please let us know if you need any immediate assistance as well as what you desire for the longer term.
File an Anonymous Report

*Please note that if you are an employee filing a mandated report, you are not permitted to use this Anonymous Report form. Please use the File a Report section, above.

File a General Campus Incident Report (non-Title IX)

Campus Incident Report Form

  • This field is for validation purposes and should be left unchanged.
  • MM slash DD slash YYYY
  • MM slash DD slash YYYY
  • :

  • Individuals Involved:

  • List any other individuals, including name, building, room number and telephone number.
  • Drop files here or
    Max. file size: 5 MB.
    File an Appeals Form

    Title-IX-Appeal-Request-Form