Behavioral Intervention Team Incident Referral

To make a referral to the Behavior Intervention Team, please complete the form below, which will be directed to the Student Conduct Office, located in the Library Building, room 418. If you should have any questions, feel free to call the office at 718-631-6314 with any additional comments or questions you may have. Please know that while it is not required that you include your contact information in the report, we do request it in the event that we need to reach out to you for further information.

When completing the Description of Behavior section below, please describe the student behavior in concise, objective language. Please note that if there is an imminent threat to anyone’s safety or if an emergency is in progress, please call our Public Safety Office immediately at ext. 6320.

* Student Full Name (First, Middle, Last):

Your Name:

Your Title:

Your Phone:

* Your Email Address:


* Date of Incident:

* Time of Incident:

* Location of Incident:

Description of Behavior:




Prove you’re not a robot

*Math Challenge.

Math Challenge Will Appear Here *Enter Math Answer: 


  

* Required

Campus Cultural Centers

Kupferberg Holocaust CenterOpens in a new window
Kupferberg Holocaust Resource Center and ArchivesOpens in a new window

Using the lessons of the Holocaust to educate current and future generations about the ramifications of unbridled prejudice, racism and stereotyping.

Queensborough Performing Arts CenterOpens in a new window
QPAC: Performing Arts CenterOpens in a new window

QPAC is an invaluable entertainment company in this region with a growing national reputation. The arts at QPAC continues to play a vital role in transforming lives and building stronger communities.

Queensborough Art GalleryOpens in a new window
QCC Art GalleryOpens in a new window

The QCC Art Gallery of the City University of New York is a vital educational and cultural resource for Queensborough Community College, the Borough of Queens and the surrounding communities.