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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 304.829.7744 or 911.

The college’s Title IX Coordinator oversees compliance with all aspects of the sex/gender harassment, discrimination and misconduct policy. The Coordinator reports directly to the President of the College, 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 university Title IX Coordinator:

Khali M. Carpenter, Esq.
Director of Student Conduct
Title IX Coordinator/Section 504 Coordinator
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 all on-campus employees, excluding the College Counselor and College Chaplain, as ALL other Bethany College employees are mandated reporters. Online reporting is available under the Complaints, Reporting, and Appeals Forms tab.

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 Complaint

File a Complaint

  • 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 complaint? 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.
  • This field is for validation purposes and should be left unchanged.
File an Anonymous Complaint
File an Incident Report

Campus Incident Report Form

  • 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.
    • This field is for validation purposes and should be left unchanged.
    File an Appeals Form

    Title-IX-Appeal-Request-Form