CAMPUS SECURITY AUTHORITY CRIME & INCIDENT REPORT

Victim Information

It is the policy of TCC to ensure that victims of and witnesses to crime are aware of their right to report criminal acts to the police and to report college policy violations to the appropriate office (i.e. student conduct violations to the Campus Dean of Student Services, employee conduct violations to the Office of Human Resources). However, if a reporting person requests anonymity, this request must be honored to the extent permitted by law. Accordingly no information should be included on this form that would personally identify the victim without his/her consent.

Gender

Age

Please enter a number from 0 to 150.

Victim is a:

Provide Name and Contact Information of victim if he/she gives permission:

First Name

Last Name

Phone

Email

Address

Street Address

Address Line 2

City

State / Province / Region

ZIP / Postal Code

Country

Is the victim willing to provide his/her name for security/police follow-up?

Has the victim made a TCC Security Report?

Has the victim made a police report?

To which police agency?

Has a Student Conduct Code/Disciplinary referral been made?

Has a referral to the Office of Human Resource been made?

CAMPUS SECURITY AUTHORITY CRIME & INCIDENT REPORT

Step 1 of 5

Campus Security Authority Information:

Incident Information

VAWA Offences

Incidents Involving Arrests or Judicial Referrals

Victim Information

Offender Information (provide known or reported information)

Incident Details