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CSA Reporting Form
Your Name
*
Your Title
*
Phone Number
*
Have you learned of a Clery Act crime that has not previously been reported to CUPD, OSC, or the OIEC?
*
Yes
No
If "no," click the "No" box and submit this form. If "yes," continue.
When was the crime reported to you?
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Month
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Clery Crime Committed?
Yes
No
Did you witness or receive a report of any of the criminal offenses listed below? Criminal homicide, murder and non-negligent manslaughter, manslaughter by negligence, rape, fondling, incest, statutory rape, robbery, aggravated assault, burglary, motor vehicle theft, arson
VAWA Crime Committed?
Yes
No
Did you witness or receive a report of any of the VAWA offenses? These include: dating violence, domestic violence, or stalking.
Hate Crime Committed?
Yes
No
Did you witness or receive a report of any hate crimes? For Clery reporting purposes, a hate crime includes: any of the criminal offenses listed above; or any of the VAWA offenses listed above; or larceny, simple assault, vandalism, or intimidation; or any other crime causing bodily injury. When the perpetrator was motivated by the victim’s actual or perceived: race, religion, gender, gender identity, sexual orientation, ethnicity, national origin, or disability.
Campus disciplinary action taken?
Yes
No
Did you witness or receive a report of arrests or referrals for campus disciplinary action for any of the following offenses: violation of local weapon laws, violation of local drug laws, or violation of liquor laws?
Reporting Method
Yes
No
Was this crime previously reported to CUPD Dispatch (303-492-6666), the Office of Student Conduct (including through normal Residence Life reporting channels), or the Office of Institutional Equity and Compliance?
Crime Location
When did the incident occur?
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Month
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Please offer a brief description of the crime
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