Initial CPH Violation Report Form

To be filled out and submitted to the College Panhellenic President or Advisor within 30 calendar day of the alleged violation. If completing online please email to Panhellenic@bucknell.edu.

Violation Reported By:

_____ Chapter representative _____ Potential Member _____ Panhellenic Officer

_____ Recruitment Councelor/Chair _____ Panhellenic Advisor

Against:

_____________________________________________________________________________________

For Violating:

Statement of Alleged Infraction

Date: ______________ Time: ______________ Location: ___________________________

Person Reporting the Incident: __________________________________________________________

Witness(es) to Incident: ________________________________________________________________

_____________________________________________________________________________________

Description of Incident: _______________________________________________________________

_______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Names and Affiliation of individuals and chapters involved: _________________________________

__________________________________________________________________________________________________________________________________________________________________________

Contact Information for individuals and chapter/s reporting the incident: ______________________

____________________________________________________________________________________

To be Completed by the College Panhellenic

Recievied by: _____________________________

^{Name and Title}

Date: ___________ Time: ____________

Notification Sent: Y N

To: Cited Chapter Y Advisor Y

Signed by: _________________________________

^{Name and position}

__________________________________________

^{Name and position}