Title IX Annual Report Form

Each TBR institution must submit an annual Title IX report to the System Office by Friday, August 11, 2023.

Instructions for Title IX Coordinator: Use this checklist to ascertain your institution’s compliance with Title IX. If you decide not to certify compliance status, then your institution has a duty to follow up on any deficiencies which affected that decision.

Services from this institution are provided to employees, applicants, students and other parties without regard to gender.
An employee has been appointed to serve as the Title IX Coordinator for the institution.
A written procedure exists for hearing Title IX complaints for all parties.
Records are maintained regarding all alleged cases of gender based discrimination or harassment.
Title IX posters are prominently displayed and are used to emphasize the Title IX program and complaint procedures.
All parties are specifically informed about their responsibilities under Title IX.
New employees are clearly informed about their responsibilities under Title IX.
Contracts between the institution and vendors/sub-contractors contain provisions regarding the vendor/sub-contractor responsibilities to clients under Title IX standards.

If you are not able to indicate “yes” to any of these standards found on the web form below, you must submit documentation to state reason(s) for non-compliance and measures to be taken.

Campus Information

Name of Institution *

Name of Person Submitting Report *

If the person submitting the report is not the institution's Title IX Coordinator, list the Title IX Coordinator here.

Name of President *

Campus Compliance

Please indicate your institution's compliance with the following statements.

Does your institution have a written policy stating that services will be provided to all persons without regard to gender? *

Are posters containing Title IX information prominently displayed? *

Do the Title IX posters and website information include the Coordinator's name, title, email address, and telephone number? *

Do all contracts to provide services contain a Title IX statement of compliance as required by TBR Guideline G-030: "Contracts and Agreements"? *

Are physical areas provided on a non-discriminatory basis with respect to gender? *

Is your institution in compliance with TBR Policy 1.12.01.00 (Records Retention and Disposal)? *

Is Title IX information disseminated to your beneficiaries (i.e. employees, applicants, students, etc.)? *

If yes, describe how all beneficiaries are informed. *

Orientation/In-Service/Staff Meetings

Application/Program Materials

Printed Materials: Newsletters/Handbooks/Posters/Flyers/Brochures

Student Information Sessions

Electronic: Email Notification/Website

Annual Training

Other

Are beneficiaries made aware of their rights under Title IX, including the right to file a complaint? *

Are new employees informed about their specific responsibilities to recipients of services under Title IX? *

Are all employees periodically trained regarding information detailing their Title IX responsibilities? *

Who conducts the Title IX employee training? *

Who is required to participate in the "Report=Support" Sexual Assault Prevention Employees training? *

List the faculty/staff completion rate of the "Report=Support" employee training in fiscal year 2022-2023. Please note the total institution completion rate (%) to include new/all employees (full-time, part-time, and contract employees). *

Does your institution routinely contact the TBR Office of General Counsel for legal advice during the investigation? *

If your institution received NO Title IX complaints during 2022-23 fiscal year, check box below:

No complaints.

Please record any complaints filed with your office during the 2021-22 Fiscal Year.

If your institution had less than 5 complaints, enter the information here.

More than 5 should be uploaded as an Excel file with the required fields.

Complaints Filed

	Date complaint was filed.	Gender of complainant	Basis for the charge	Formal complaint under Sexual Misconduct Policy	Brief summary (50 words or less)	Findings/Conclusions	Current Status
Complaint #1	Month Day Year
Complaint #2	Month Day Year
Complaint #3	Month Day Year
Complaint #4	Month Day Year
Complaint #5	Month Day Year

Complaints: If your institution had more than 5 complaints, upload the file here.

Files must be less than 2 MB.
Allowed file types: xls xlsx.

Declaration of Respondent and Administrative Head

I declare that I have completed the data in this survey and to the best of my knowledge and belief, it is true, correct, and complete.

Title IX Coordinator (or person completing form). *

Email of Person Submitting the Report *

Was this information reviewed by your President before submission? *

President's Email to Send Confirmation *

Leave this field blank

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