Gender-based Violence ReportStep 1 of 333%Is this report on behalf of:(Required) Yourself Someone elseAre you:(Required) I am a current resident at Graduate House I am a staff member of Graduate House I am a member visitor to Graduate House I am a visitor to Graduate House I am to remain anonymous OtherHow do you identify your gender:(Required) Woman Man Prefer not to say Anonymous OtherName(Required) Dr.MissMr.Mrs.Ms.Mx.Prof.Rev. Prefix First Last Email(Required) Date of incident:(Required) Time of incident:(Required) Hours: MinutesLocation:(Required) At Graduate House At University grounds OtherDescription is Incident:(Required)Action Taken:(Required)Any report goes to my email only please in om@graduatehouse.com.au.Email(Required) Why are you reporting anonymously? (Select all that apply)(Required) I’m worried that I won’t be believed The victim did not want to report it themselves I cannot prove the behaviour took place I’m worried that there would be repercussions in my social circle I don’t have time to make a complaint I’m worried the perpetrator would retaliate I don’t want anyone to know it took place I’m worried about being called a troublemaker Nothing would be done if I made a complaint Making a complaint would have a negative impact on my health I feel too embarrassed or ashamed I don’t know how to make a complaint I don’t want to get the other person/people into trouble I feel partly to blame for what happenedAny other concerns that make you want to report anonymously?Have you sought support? (Select all that apply)(Required) Yes – I have sought support from a friend or family member Yes – I have sought support from an external support organisation No – but I will seek support soon No – I have not sought supportWhen did the incident take place? If there have been a series of incidents, choose the timeframe of the most recent incident.(Required) In the last week In the last month In the last year Over a year agoTime of incident: Hours: MinutesWhere did the incident take place?(Required) On College property On University property OtherThe alleged offender(s) was/were: (Select all that apply)(Required) A Resident of Graduate Hosue A staff member of Graduate House Someone known to me/the victim A stranger to me/the victim Other / I am not sureWhat type of behaviour took place during the incident? (Select all that apply)(Required) Inappropriately showing sexual organs Sharing private sexual materials of another person without consent (eg circulation via social media, private messaging or in person) Engaging in sexual intercourse or a sexual act without consent (including ‘stealthing’) Kissing without consent Inappropriate touching without consent (including through clothes) Creating or contributing to a sexualised environment through constant inappropriate leering, joking, wolf-whistling, commenting on a person’s sexuality or behaviour, slut-shaming or other behaviours designed to belittle the victim OtherIf Other, please provide more details on the behaviour that took placeAre you able to identify the alleged offender(s)? Please note that if the alleged offender(s) is not identified, the College is unable to address their behaviours directly.(Required)Further Comment? Any further details to clarify or expand on your responses, or that may help us ensure that the College continues to be a safe and respectful environment.
