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About CSU
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Concerned Vikes
Free Speech at CSU
Board of Trustees
President's Office
Admissions
Undergraduate
Graduate
International
Law
Online
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Financial Aid and Scholarships
Tuition and Fees
Pre-College Programs
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Campus Security Authority Crime Report Form
CSA Name
E-Mail
Phone Number
Date of Report
Who Reported The Crime? (If the reporter is the victim and wishes to remain anonymous, do not complete this field.)
Reporter's Contact Information?
Relationship Between Reporter and Victim?
Self
Witness
Offender
Other
Does the victim wish to remain anonymous?
Yes
No
If no, who is the victim?
Who is / are the offender(s) (if known)?
What Clery crime(s) occurred? (select all that apply)
Murder or non-negligent manslaughter
Negligent manslaughter (including vehicular manslaughter)
Sex offenses, inclusing rape, fondling, incest and statutory rape
Domestic violence
Dating violence
Stalking
Robbery
Aggravated assault
Burglary
Motor vehicle theft
Arson
Liquor law violation(s)
Drug law violation(s)
Weapon law violation(s)
Hate Crime(s)
Provide any details you have of the incident:
Are you aware of the incident being reported to any law enforcement agency or to another CSA?
Yes
No
When did the incident occur?
Where did the incident occur?
Did the incident occur (if known)?
In a building
In a public area
On campus
At a University-sponsored activity
This form is only for Campus Security Authorities to report a Clery crime. Any other crime reporting should be submitted to the University Police department by calling (216) 687-2020.
I understand that this form is only for CSAs to submit Clery crime reports.
Submit