CREC Incident Report
Date/Time of Incident
*
-
Month
-
Day
Year
Date
Hour Minutes
AM
PM
AM/PM Option
Location of Incident
*
Information of Person Submitting a Report
Your Full Name
*
Your W Number
*
Your Email
*
Must Be Your School Email
Your Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
People Involved
Person #1 Name
*
Person #1 W Number
Person #1 Status
*
Please Select
Student
Staff/Faculty
Community
Other
Unknown
Person #2 Name
*
Person #2 W Number
Person #2 Status
*
Please Select
Student
Staff/Faculty
Community
Other
Unknown
University Officials Involved
*
None
Campus Police
Emergency Medical Services
Silver City Police Department
Vice President of Student Affairs
Description of the Incident
*
Write in 3rd person and only state the facts. Make sure to include the names of all people present and involved. Describe behaviors and quotes (profanity is acceptable if in quotes); maintain chronological order of events. Provide specific details of time, place, names, and room numbers or addresses of individuals and witnesses.
Images/Footage of the Incident
*
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