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Sexual Misconduct (Title IX) Incident Report Form

Individuals who feel they have been a victim/survivor of sexual misconduct have the right to file a complaint with the College at any time, even if the police conclude there is not sufficient evidence for a criminal charge. A Title IX Complaint may be filed utilizing the Title IX Complaint Form below.

Stop! Confidentiality may not be able to be maintained. Learn about confidential reporting.

For additional assistance with filing a Title IX complaint you may contact:

Michelle Merritt
Interim Title IX Coordinator
Associate Dean of Students
Room 21, Poling Hall (lower Level)
(309) 457-2114

Karen Ogorzalek
Interim Deputy Title IX Coordinator
Associate Dean of Students and Director of Campus Events
Room 109, Stockdale Center (main level)
(309) 457-2345


Individuals may also contact the U.S. Department of Education's Office of Civil Rights for additional information.

Office for Civil Rights
U.S. Department of Education - Chicago Office
500 W Madison St., Suite 1475
Chicago, IL 60661-4544

How to Use This Form

Use this form to report:

  • Dating Violence
  • Domestic Violence
  • Gender-based Discrimination or Harassment
  • Sexual Harassment
  • Sexual Assault
  • Stalking

For definitions of each, please see the Monmouth College Policy Prohibiting Discrimination, Harassment, and Retaliation.

Please provide as much information as possible. THIS FORM MAY BE SUBMITTED ANONYMOUSLY. The fields marked with a red asterisk (*) are required.

What Does Filing an Anonymous Complaint Mean?

When a complainant's (victim's) identity is unknown or requests to remain confidential the Title IX Coordinator is responsible for reviewing the request and the facts of the case to determine if confidentially can be maintained.

If there is a likelihood of further harm to the complainant and/or the campus community, confidentially may not be able to be maintained. When confidentially is maintained or the complainant’s identity is unknown the College’s ability to take appropriate disciplinary action may be impeded. However, the College will attempt to take steps to address and remedy the effects of the sexual misconduct to prevent reoccurrence.

If a complainant requests to withdraw a formal complaint the Title IX Coordinator or designee will make every effort to determine the reason for the reconsideration. We want to make sure the complainant isn’t being harassed or retaliated against.

These incident reports are for reporting non-critical or non-emergency incidents.
If you have an emergency situation, please contact:
• Campus Safety at 309-457-3456 or 911 (on-campus emergencies)
• City of Monmouth Police at 309-734-8383 or 911 (off-campus emergencies)

Questions? Please contact the Office of Student Affairs at 309-457-2114 or

Submit a Sexual Misconduct (Title IX) Incident Report

Contact Us

Office of Student Affairs
Poling Hall (main level), Room 123