NOTE: This form is not meant to replace the standard reporting procedure. If you are the victim of a crime please call Police Services at 678-4357. Please also note that the submission of this form generates an e-mail message to the Director of Police Services, who may share its content with the appropriate officials.

Type of crime you witnessed (Drug use/selling, theft, rape, assault, disturbance, vandalism, or any other type):

Where on campus did this event occur? Be as specific as possible:

When did it occur? (Dates/Times):

Detailed Information or Comments (Who/What/When/Where, Vehicle Description, etc):

Description of Individual(s) Involved in the Crime:

Name of Individual(s) Involved in the Crime (if known):

Other Comments (if any):

You may enter your personal information below, if desired. If not, you may press the Submit button below now.

Your Name:

Your Phone Number:

Your E-mail address:

May we contact you for more information? Yes No