The university has an expectation that employees will share information they receive about campus crime. This form is intended to convey information needed to track the university’s response to campus incidents being reported, as well as to assess the danger the incident represents to the community at large. Annual statistical information will be based on this report, as will the need to make timely warnings to the community, for the protection of those who may be at risk.

Instructions: Fill in all fields that apply. Report only one incident per form. Provide as much relevant detail as possible. Submit this form within 24 hours of becoming aware of any incident

* Required

Your Information

Reported to you by: (Select one) *

If you wish to avoid specifics, choose one of the options in the drop down menu below. Please refer to the location descriptions below this form for proper classification.

Choose a location. See definitions below the form.
Do you have reason to believe this incident represents a present threat of harm or danger to the victim or other member(s) of the community?
Was a weapon involved?
Role of assailant/perp on campus
Was there any evidence that this incident was motivated by the victim's (choose all that apply)

* Any field denoted with an asterisk is a field that may be left blank by you if you intend for this report NOT to serve as actual notice to the university of harassment, discrimination, sexual assault or other civil rights violation for which notice will trigger an obligatory investigation by the university. Some employees are required to complete this form in full, while others may withhold from the fields designated with an *, depending on your role. Training has been provided on what you are required to report, but if you are unsure, please consult with your supervisor.

LOCATION DESCRIPTIONS

The term ‘campus’ means:

“ any building or property owned or controlled by an institution of higher education within the same reasonably contiguous geographic area of the institution and used by the institution in direct support of, or in a manner related to, the institution’s educational purposes, including residence halls; and

property within the same reasonably contiguous geographic area of the institution that is owned by the institution but controlled by another person, is used by students, and supports institutional purposes (such as a food or other retail vendor).”

If an incident occurred on campus in a residence hall, please select both “On Campus” and “Residence Hall” on the form above.

The term ‘off-campus’ means:

“any building or property owned or controlled by a student organization recognized by the institution; and

any building or property (other than a branch campus) owned or controlled by an institution of higher education that is used in direct support of, or in relation to, the institution’s educational purposes, is frequently used by students, and is not within the same reasonably contiguous geographic area of the institution.”

The term ‘public property’ means:

“…all public property that is within the same reasonably contiguous geographic area of the institution, such as a sidewalk, a street, other thoroughfare, or parking facility, and is adjacent to a facility owned or controlled by the institution if the facility is used by the institution in direct support of, or in a manner related to the institution’s educational purposes.”