INCIDENT REPORT
IF THIS IS AN EMERGENCY OR AN IMMEDIATE RISK OF DANGER, CALL 911 OR CAMPUS POLICE AT 276/523-7473.

This form generates a report that is reviewed during business hours and should not be used if you need an immediate or emergency response.

This form is intended for the sole use of reporting incidents and student conduct violations to the Campus Police and Dean of Student Services.

In order to complete the report, you must provide the following information:
• Your name and contact information
• The name, Student ID# (if applicable), date of birth and contact information for each
individual involved in the incident as well as the date, location and a summary of the incident.


Enter YOUR e-mail address below (a copy of your completed Incident Report will be sent to the email provided below):

Email address *
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