Incident Report Form - Phi Alpha Delta Law Fraternity, International

Incident Report Form

This is the Phi Alpha Delta online incident report form. Please use this form to report potential risk-related incidents and P.A.D. policy violations. Reports and complaints may be submitted anonymously. Please be as thorough as possible to accurately portray the facts related to the incident and/or violation. If this is an emergency, please contact the Executive Director at 410-347-3118.

Student reporters are encouraged to file an incident report with their appropriate school office in addition to completing this form. Contact local law enforcement or campus police if this incident is an assault or other serious crime. If you have questions about reporting please contact the Executive Director at andrew@pad.org.

To reference the current Dispute, Conflict, and Complaint Process, please click here.

Incident Description
Do you wish your report to be anonymous? *	Yes No
Date of Incident
Where did this incident occur?
Please describe the incident that occurred using as much detail as possible. Please include the nature of your complaint or the violation you are reporting (hazing, open membership policy violation, assault, etc.). If possible, please reference the Fraternity Policy Manual section that relates to this report.
Describe the incident that occurred.
Please provide any attachments relevant to your report.If you have any documentation (such as emails, messages, photos, etc.) to support this report, please attach it here. You may redact any personal or identifying information.
If this was an incident involving students, was a report filed with your school or university?	Yes No
If applicable, please provide the details of the report filed with the school or university.Please include the name of the person or office this report was filed with, the person/office’s contact information, and the date the report was filed.
Was there a police report filed?	Yes No
If a police report was filed, please include the jurisdiction, name of agency, and case number.
Please provide a copy of the police report if possible.
Were there any witnesses to this incident?	Yes No
Please include witness name(s) and contact details if they are willing to be contacted.
Are you willing to be contacted in case a follow-up or more information is needed?	Yes No
If yes, please fill out the remainder of this form.

The following fields are optional if you are making an anonymous complaint.

First Name:		Last Name:
Chapter/School:
Email Address:
Phone Number:
Thank you for completing the Incident Form.
We will confirm receipt of this report within 3 business days. If you need to reach us immediately, please call 410-347-3118.

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Phi Alpha Delta is the world’s preeminent law fraternity because of our dedication to service: service to the student, the school, the profession, and the community.

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Phi Alpha Delta Law Fraternity, International
606 Baltimore Avenue
Suite 303
Towson MD 21204
Phone: 410-347-3118
Email: info@pad.org
Office Hours: M-F, 9am-5pm ET
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