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Campus Safety Incident Report (Clery Act)
Incident report form used by colleges and universities to document crimes and safety incidents as required by the Jeanne Clery Disclosure of Campus Security Policy and Campus Crime Statistics Act.
PDF TemplateUse the instructions below to complete this form
Instructions
Document the type of incident, date, time, and location (on-campus, public property adjacent to campus, or non-campus property). Identify reporting parties and witnesses. Clery-reportable crimes include murder, sexual assault, robbery, aggravated assault, burglary, motor vehicle theft, arson, hate crimes, and VAWA offenses. Campus security authorities must report incidents promptly. The institution must issue timely warnings for ongoing threats to the campus community.