Police and Public Safety

CSA Crime Statistics Reporting Form

Instructions:

  • If you are reporting a serious crime or incident that may cause an imminent or ongoing threat to the campus community, immediately call Mason Police at 9-1-1 or (703) 993-2810. If there is any question about whether an ongoing threat exists, please contact Mason Police.
  • If you are reporting a Clery Act Crime statistic that does not pose an imminent or ongoing threat to the campus community and has not already been reported to Mason Police, please complete the following form with as much relevant details as possible.
  • For questions please contact the Clery Act Compliance Coordinator at (703) 993-5497 or [email protected].

Campus Security Authority (CSA) Crime Statistics Reporting Form

  • IMPORTANT REMINDER

    It is the policy of George Mason University to ensure that victims and witnesses to crimes are aware of their right to report criminal acts to the police and to report University Policy violations to the appropriate office (e.g., student conduct violations to the Dean of Students). However, if a reporting person requests 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. Based on information received, GMU Police will determine the category of the crime or incident and the location under which the incident should be reported in the Annual Security Report. Clery and associated legislation requires that each department's records related to the Clery reportable crime statistics be retained for seven years.
  • Clear Signature
    By signing this form you are agreeing that this crime report is being made in good faith and is consistent with your roles and responsibilities as a Campus Security Authority (CSA) at George Mason University pursuant to University Policy 1412 (Reporting of Clery Act Crimes and/or Prohibited Sexual Conduct).
  • This field is for validation purposes and should be left unchanged.