CSA INCIDENT REPORT
FOR
CAMPUS SECURITY AUTHORITIES
BRISTOL COMMUNITY COLLEGE
The purpose of CLERY is to encourage reporting and the accurate collection of campus crime statistics to promote crime
awareness and to enhance campus safety through reliable statistical records. The purpose of this report form is to
provide a uniform procedure for documenting the (What, When, Where) of certain reportable crimes and/or non-
criminal hate motivated incidents that have occurred within one of the three reporting locations described below and
which have been reported to a Campus Security Authorities (CSA) other than the Bristol Community College Police
Department. Data collected on this form is used to increase public safety, not to identify the victim; therefore, no
personal identifying information shall be included on this form. All cooperating victims who do not wish to remain
anonymous should be directed to the Bristol Community College Police Department or the law enforcement agency
having jurisdiction where the crime occurred.
It is the policy of Bristol Community College to encourage victims and/or witnesses to crime(s) to report such crimes to
the police and/or to a designated Campus Security Authority. For the purposes of CLERY, CSA’s are required to
document certain reportable crimes and non-criminal hate motivated incidents which have been reported to them, and
which have occurred in the following locations:
1) On-campus property: Offense statistics for any building or property owned or controlled by the College within the
same reasonably contiguous geographic area and used by the College in direct support of, or in a manner related to, the
College's educational purpose, including buildings or property the location described herein that is owned by the College
but controlled by another person and which is frequently used by students.
2) Non-campus property: Offense statistics for non-campus property or building owned or controlled by the College
that is frequently used by students and is not within the same reasonably contiguous geographic area of the institution,
or any building/property that is owned or controlled by a student organization that is officially recognized by the
institution.
3) Public property: Offense statistics for public property located immediately adjacent to and accessible from campus,
including: thoroughfares, sidewalks, streets, lands, parks and beaches.
For CLERY purposes, the student status (yes/no) of the offender or the victim is not a relevant fact as to whether or
not this report form is to be completed. If a violation of one of the 14 listed offenses occurs, documentation is
required.
CLERY documentation is not satisfied by simply directing/referring the reporting party to the police department. In
order for the College to satisfy the statistical reporting requirements of the Clery Act, all CSA’s are required to
complete this form when certain any of the specified offenses list below are reported to them. Nonetheless, a person
reporting a crime shall also be encouraged to report the crime to the Bristol Community College Police Department.
□ Homicide □ Aggravated Assault □ Burglary □ Alcohol violations
□ Manslaughter □ Sex Offense (Forcible) □ Arson □ Drug/Narcotic violations
□ Robbery □ Sex Offense (Non-forcible) □ Weapons violations □ Motor Vehicle Theft
□ Hate Crime (Please Select Sub-Type)
□ Bodily injury □ Vandalism □ Email
□ Telephone □ Message □ Other
□ Hate Incident (any non-criminal incident)
Category of Prejudice
□ Ethnicity □ Gender
□ Race □ Disability
□ Religion □ National Origin
□ Sexual Orientation
□ On-campus
□ Public property
□ Unknown
□ Non-campus property
Date of Incident:
Time of Incident:
