Threat Assessment Team Referral Form

This referral form is designed to enable faculty, staff and students to voluntarily report “red flag behaviors” that may raise concerns and incidents of student/employee misconduct at Connors State College.  An incident, in this context, is an event that does not warrant immediate intervention.  In the event of an emergency that requires immediate intervention, call 911 or Campus Security.  The referral form will provide a mechanism for responding to individual incidents and will reveal patterns of disruptive behavior of specific students/employees.  It will also provide aggregate data on the nature and frequency of disruptions at Connors State College.  This report provides a standardized method for recording observations of troublesome behaviors and for alerting staff of potential concerns.  In accordance with Connors State College policy, information provided in the Threat Assessment Team Referral Form may also be considered in determining appropriate disciplinary action with students/employees.

Student /Employee information: (please enter as much information as possible)

Fields marked with a * are required.