CSA Reporting Form
Introduction - The Federal Jeanne Clery Disclosure of Campus Security Policy and Campus Crime Statistics Act, otherwise known as the Clery Act (Act), applies to certain crimes reported to the police and other College officials known as Campus Security Authorities (CSA). The Act defines CSA’s as mandated crime reporters. As such, CSA’s are required to report any Act qualifying crimes that they are made aware of to the Bennett College Safety and Security. Timely reporting of crimes is encouraged and sometimes required. Safety and Security will use the submitted information to verify the appropriate crime classification and to compile statistics to be included in the Annual Security Reports that Bennett College publishes and distributes each fall.
If a crime has recently occurred, or you need assistance with information on this form please notify the Bennett College Department of Campus Safety right away at (336) 370-8621 to assist and additionally decide if a timely warning needs to be generated.
An * indicates a required field.
Submission –Please fax (336-370-8718) or mail the printed Crime Report Form to: Bennett College Department of Public Safety, 900 East Washington Street, Greensboro, NC 27401 or email:
Crime Reporting – It is the policy of Bennett College to ensure that the victims and witness to crimes are aware of their right to report criminal acts to the Bennett College Safety and Security 336-370-8621. CSA’s should ask reporting party if they would like to report the crime to Safety and Security. If the reporting party wants Safety and Security contacted, the CSA should contact them and if the CSA can verify that Safety and Security responded and took a report, then it is not necessary for the CSA to complete and submit this form. However, if the CSA can’t verify that Safety and Security responded and took a report, then the CSA must complete and submit this form.
Anonymity – If a crime reporting party request 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.
Criminal Homicide Murder & Non-negligent Manslaughter – The willful (non-negligent) killing of one human being by another.
Negligent Manslaughter – The killing of another person through gross negligence.
Sex Offenses-Forcible – Any sexual act directed against another person, forcibly and/or against that person’s will; or not forcibly or against the person’s will where the victim is incapable of giving consent because of his/her temporary or permanent mental or physical incapacity.
Forcible Rape – The carnal knowledge of a person, forcibly and/or against that person’s will; or not forcibly or against the person’s will where the victim is incapable of giving consent because of his/her youth or because of his/her temporary or permanent mental or physical incapacity.
Sexual Assault with an object – The use of an object or instrument to unlawfully penetrate, however slightly, the genital or anal opening of the body of another person, forcibly and/or against that person’s will; or not forcibly or against the person’s will where the victim is incapable of giving consent because of his/her youth or because of his/her temporary or permanent mental or physical incapacity.
Forcible Sodomy – Oral or anal sexual intercourse with another person, forcibly and/or against that person’s will; or not forcibly against the person’s will where the victim is incapable of giving consent because of his/her youth or because of his/her temporary or permanent mental or physical incapacity.
Forcible Fondling – The touching of the private body parts (the sexual organ, anus, groin, or buttocks, breast of a female) of another person for the purpose of sexual gratification, forcibly and/or against that person’s will where the victim is incapable of giving consent because of his/her youth or because of his/her temporary or permanent mental or physical incapacity
Sex Offense Non-Forcible – A) Incest – Non-forcible sexual intercourse between persons who are related to each other within the degrees wherein marriage is prohibited by law. B) Statutory
Rape – Non-forcible sexual intercourse with a person who is under the statutory age of consent.
Robbery – The taking or attempting to take anything of value from the care, custody, or control of a person or persons by force or threat of force or violence and/or by putting the victim in fear.
Aggravated Assault – An unlawful attack by one person upon another for the purpose of inflicting severe or aggravated bodily injury. This type of assault usually is accompanied by the use of a weapon or by means likely to produce death or great bodily harm. (It is not necessary that injury result from an aggravated assault when a gun, knife or other weapon is used which could and probably would result in serious personal injury if the crime were successfully completed.) This type of assault usually requires more than first aid.
Other Assaults-Simple, Not Aggravated – All other assaults that do not use the use of a firearm, knife, cutting instrument or other dangerous weapon and in which the victim did not sustain serious or aggravated injury. This type of assault may require basic first aid.
Burglary – The unlawful entry of a structure to commit a felony or theft. For reporting purposes this definition includes: unlawful entry with intent to commit a larceny or felony; breaking and entering with the intent to commit a larceny; housebreaking; safecracking; and all attempts to commit any of the aforementioned.
Larceny-Theft – The unlawful taking, carrying, leading or riding away of property from the possession or constructive possession of another.
Motor Vehicle Theft (Stolen Vehicle) – The theft or attempted theft of a motor vehicle. (Classify as motor vehicle theft all cases where automobiles are taken by persons not having lawful access even though the vehicles are later abandoned—include joyriding.)
Arson – Any willful or malicious burning or attempt to burn, with or without intent to defraud, a dwelling house, public building, motor vehicle or aircraft, personal property of another, etc.
Vandalism – To willfully or maliciously destroy, injure, disfigure or deface any public or private property, real or personal, without the consent of the owner or person having custody or control by cutting, tearing, breaking, marking, painting, drawing, covering with filth or any other such means as may be specified by local law.
Intimidation – To unlawfully place another person in reasonable fear of bodily harm through the use of threatening words/or other conduct, but without displaying a weapon or subjecting the victim to actual physical attack.
Domestic violence – includes asserted violent misdemeanor and felony offenses committed by the victim's current or former spouse, current or former cohabitant, person similarly situated under domestic or family violence law, or anyone else protected under domestic or family violence law.
Dating violence – means violence by a person who has been in a romantic or intimate relationship with the victim. Whether there was such relationship will be gauged by its length, type, and frequency of interaction
Stalking – means a course of conduct directed at a specific person that would cause a reasonable person to fear for her, his, or others' safety, or to suffer substantial emotional distress.
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