Accommodation Misconduct Report Form

University of Hull

Accommodation Misconduct Report Form (AMR)

For use in cases of suspected student misconduct in University of Hull Accommodation

For completion by staff on behalf of student(s) reporting an incident(s) (students must be made aware of the principles of natural justice before completing this form)

Name of Staff Member Completing this Form*

First Name

Last Name

Email of Staff Member Completing this Form*

Phone Number of Staff Member Completing this Form*

Reporting Student(s) Information (if applicable)

Name of Reporting Student (Complainant) - (If there are more than two reporting students please add their details in the additional information section)

First Name

Last Name

Email of Reporting Student (Complainant)

Phone Number of Reporting Student (Complainant)

Student Number of Reporting Student (Complainant)

Residence of Reporting Student (Complainant) if they Reside in UoH/UPP Accommodation

Is there an Additional Reporting Student?

Name of Reporting Student (2)

First Name

Last Name

Email of Reporting Student (2)

Phone Number of Reporting Student (2)

Student Number of Reporting Student (2)

Residence of Reporting Student (2) if they Reside in UoH/UPP Accommodation

Student(s) Suspected of Accommodation Misconduct

Name of Reported Student (Student suspected of misconduct)*

First Name

Last Name

Student Number of Reported Student (Student Suspected of Misconduct)*

Residence of Reported Student (Student Suspected of Misconduct)*

Is there a 2nd Student being Reported?*

Name of Reported Student (2)*

First Name

Last Name

Student Number of Reported Student (2)*

Residence of Reported Student (2)*

Is there a 3rd Student being Reported?*

Name of Reported Student (3)*

First Name

Last Name

Student Number of Reported Student (3) *

Residence of Reported Student (3)*

Is there a 4th Student being Reported?*

Name of Reported Student (4)*

First Name

Last Name

Student Number of Reported Student (4)*

Residence of Reported Student (4)*

Is there a 5th Student being Reported? *

Name of Reported Student (5)*

First Name

Last Name

Student Number of Reported Student (5)*

Residence of Reported Student (5)*

Is there a 6th Student being reported? *

Name of Reported Student (6)*

First Name

Last Name

Student Number of Reported Student (6)*

Residence of Reported Student (6)*

Is there a 7th Student being reported?*

Name of Reported Student (7)*

First Name

Last Name

Student Number of Reported Student (7)*

Residence of Reported Student (7)*

Is there a 8th Student being reported?*

Name of Reported Student (8)*

First Name

Last Name

Student Number of Reported Student (8)*

Residence of Reported Student (8)*

Details of Alleged Misconduct

Date/Time of Alleged Misconduct

Location Where Alleged Misconduct Took Place

Please Provide Details of Alleged Misconduct*

Please upload any supporting evidence

No File Chosen

File uploads may not work on some mobile devices.

For example; photographs, screenshots, emails

No File Chosen

File uploads may not work on some mobile devices.

No File Chosen

File uploads may not work on some mobile devices.

Witness Information (if applicable)

Witness Name (If there are more than 3 witnesses please add their details in the additional information box)

First Name

Last Name

Witness Student Number

Witness Email

Witness Phone Number

Is there a 2nd Witness?

Witness (2) Name

First Name

Last Name

Witness (2) Student Number

Witness (2) Email

Witness (2) Phone Number

Is there a 3rd Witness?

Witness (3) Name

First Name

Last Name

Witness (3) Student Number

Witness (3) Email

Witness (3) Phone Number

Additional Information

Please outline any additional information relevant to the case, including additional complainants/witnesses, any immediate precautionary action taken, or any other action which may have been taken (i.e. arranging emergency/alternative accommodation)

If immediate precautionary action has been taken please upload relevant documentation (i.e. the follow-up email to the student and/or receipt for sound making equipment)

No File Chosen

File uploads may not work on some mobile devices.

Immediate precautionary action includes; direction to leave and confiscation of sound making equipment

No File Chosen

File uploads may not work on some mobile devices.

Staff Member Declaration

Declaration; I confirm that I am submitting this report form (Please select one option from the below list)*