Interpersonal Violence Anonymous Report Form
NCSU Women’s Center
The purpose of the Anonymous Report Form is to allow members of the NC State University community (students, staff, or faculty) to anonymously report incidents of sexual violence, relationship violence, and stalking. This form should be used by anyone who is a victim/survivor, or is responding to a victim/survivor of interpersonal violence specifically, sexual or relationship violence including stalking.
The form below is intended for the anonymous reporting of all forms of interpersonal violence. NC State University’s Alliance for Sexual Assault Prevention (ASAP) will use this form to allow victim/survivors – as well as others with whom they discuss these incidents – to bring the misconduct to the attention of the Women’s Center. The data collected through this report will help the University better understand the campus climate and work to create a safer campus community.
In using this form, all efforts must be made to maintain the victim/survivor’s anonymity. No information should be included that might identify the victim/survivor, unless you choose to do so as the victim/survivor, or if you are asked to do so by the victim/survivor.
Please Note: Completion of this form will NOT initiate a police report nor a judicial referral to the Office of Student Conduct. You will NOT be contacted by anyone unless you indicate a desire to be contacted. If you would like to submit a report to the NC State University Police Department, which could commence an investigation, you may do so online at http://www.ncsu.edu/police.
The following are a list of general definitions of forms of interpersonal violence. They are here to help you if you are unsure of what to call the experience that you are reporting.
Relationship Violence – Relationship violence is a pattern of abusive behaviors that are used to control a person in a relationship. Someone is in a relationship in which they are being abused when one partner doesn’t respect the rights and wishes of the other partner. This relationship can be between people of different or the same sex. There are different kinds of abuse that can take place during dating such as physical abuse, emotional abuse, psychological abuse, sexual abuse, and stalking.
Stalking – Stalking is a pattern of unwanted behavior directed towards one person that would cause a reasonable person to feel fear. This can be done in person directly or through a third party, or through electronic contact such as text, Facebook or My Space messages, IM, emails, tweeting, or telephone.
Sexual assault – Sexual assault is defined as rape or any physical act of a sexual nature perpetrated against an individual without consent (see below for definition) or when an individual is unable to freely and willingly give consent. Acts of a sexual nature include, but are not limited to: touching or attempted touching of an unwilling person’s breasts, buttocks, inner thighs, groin, or genitalia, either directly or indirectly through their clothing; and/or penetration (however slight) of another person’s oral, anal or genital opening with any object, penis, or finger.
Sexual assault also includes sexual exploitation. This is when a person takes nonconsensual or abusive sexual advantage of another for his or her own advantage or benefit, or for the benefit or advantage of a third party (WW). Examples of sexual exploitation include, but are not limited to:
- Prostituting another
- Distributing photographs or recorded sexual images or activity without consent
- Viewing or downloading child pornography
- Video- or audio-taping sexual activity without the partner(s) consent
- Allowing a 3rd party to observe sexual activity without the consent of the partner(s)
- Engaging in voyeurism, peeping or indecent exposure
- Knowingly transmitting sexually transmitted infections without the partner’s knowledge.
The university’s definition of sexual assault requires that each participant obtains and gives consent in each instance of sexual activity. Consent is an affirmative decision to engage in mutually acceptable sexual activity given by clear actions or words. It is an informed decision made freely, willingly, and actively by all parties.
Behavior will be considered “without consent” if no clear consent, verbal or nonverbal, is given. In the State of North Carolina, one cannot legally give consent if they are incapacitated due to alcohol or legal or illegal drugs, or under the age of 16.
Consent cannot be procured by physical force, compelling threats, intimidating behavior, or coercion. Coercion is unreasonable pressure for sexual activity. Coercive behavior differs from seductive behavior based on the type of pressure someone uses to get consent from another. When someone makes clear to you that they do not want sex, that they want to stop, or that they do not want to go past a certain point of sexual interaction, continued pressure beyond that point can be coercive.
Someone is not giving consent if they are:
- saying “no” or “stop”
- moving away
- pushing the other(s) away
- completely still/unengaged
- passed out
- physically or psychologically pressured or forced
- coerced (i.e. manipulated or tricked)
- mentally or physically impaired
Select Resources (please click on the name of the resource for more information):
NCSU Women’s Center — 919-515-2012 or
RSVP Line (Relationship and Sexual Violence Phone Line) — 919-618-RAPE (7273) 24-hours/day
Counseling Center — 919-515-2423
University Police — 911 (on-campus) or
919-515-3000 (off-campus or from a cell phone)
Interact— 919-828-3005 (24-hour support line)
Raleigh Police Department – 911