A Safer CBC

Working Together for A Safer CBC!

Your safety is our priority! We need your help to ensure our campus community is as safe as possible.

This incident report form allows you to communicate with appropriate College officials regarding incidents that affect the safety and security of our College campus and community. Issues such as safety concerns, substance abuse and theft are serious and will end up causing more problems if not reported. This form provides you with a secure method in which to report these incidents.

Please include as much detail as you are able. Questions marked with an asterisk (*) are required. If you do not have the information requested, please indicate that by inputting "n/a." You may choose to remain anonymous, but, if you feel comfortable, we encourage you to provide contact information so that we may follow up with any questions and/or resolution.

Thank you for helping keep our campus community safe!

Please don't fill out this input box.

Type of Incident

Please choose the type of incident for which you are making this report:*

Safety – Concerns include instances in which you feel unsafe or as though your health might be threatened due to campus conditions. Concerns can include, but are not limited to fear or experience of personal assault, danger of damage to personal property, weapons policy violations, fire hazards, poor security procedures, and/or danger of unsafe construction.

Substance abuse – Concerns include instances of illegal or inappropriate drug or alcohol use. Concerns can include, but are not limited to when the following are used either inappropriately or illegally alcohol, marijuana, narcotics, amphetamines, depressants, stimulants, inhalants, hallucinogens, and/or prescription drugs.

Theft – Concerns include instances when property belonging to the College, or any member thereof, is taken without consent and with the intent to permanently deprive the owner of the property and use it as one’s own or sell it for personal gain.

Other – Please choose this type if you feel the incident you are reporting is not described above. If other, please provide your own incident type.

If other please specify the incident type

Description of the Incident

Please fill in all required fields (*). Input n/a if you do not have the information.

Date (mm/dd/yyyy)*

Time (HH:MM AM/PM)*

Location*

Please provide a detailed description of the incident.*

Describe Individuals Involved in Incident

Please provide names of any individuals you know or suspect are involved in the incident.Please separate names using commas.

Details of Incident

Did the incident occur more than once?*

If yes, how many times did it occur?

Has the incident been reported previously to anyone on campus?*

If yes, who?

Has the incident been reported to anyone off campus?*

If yes, who?

Did anyone witness this incident?*

If yes, who?

Were you the target of this behavior?*

If no, who was the target?

Was anyone injured?*

If yes, who?

Follow up

What is the best way to contact you?

Please call me.

Please email me.

Please call or email me.

I wish to remain anonymous.

Your name

Daytime phone number

Email address

Your relationship to the College

A Safer CBC

Working Together for A Safer CBC!

Type of Incident

Description of the Incident

Describe Individuals Involved in Incident

Details of Incident

Follow up

contact

Phone:509-547-0511

Address:2600 N. 20th Ave., Pasco, WA 99301

Office Hours:File a report 24 hours a day, seven days a week.College business hours:Monday to Thursday: 7 am to 4 pmFriday: 7 am to noon

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A Safer CBC

Type of Incident

Description of the Incident

Describe Individuals Involved in Incident

Details of Incident

Follow up

Phone:509-547-0511

Address:2600 N. 20th Ave., Pasco, WA 99301

Office Hours:File a report 24 hours a day, seven days a week.College business hours:Monday to Thursday: 7 am to 4 pmFriday: 7 am to noon