Clery Crime Reporting Form

Clery Crime Reporting Form for Campus Security Authorities

Campus Security Authority Name

Campus Security Authority Email Address

Date form submitted [None]

Date crime was reported to you

Crime Reported by

This person is a

Contact information for this person (optional)

Date incident occurred

Location of incident

Description of the event

Did the crime occur in a building or on a street?

Building name

Street name

Did the crime occur on Hendrix owned, controlled, or leased property?Yes No

Did the crime occur at a Hendrix-sponsored activity or event?Yes No

Do you believe this incident is bias-related (hate crime)?Yes No

If so, which category of bias

Sex Offense- ForcibleForcible RapeForcible FondlingIncestStatutory Rape

Hate Crime Additional Offenses

If a hate crime occurs where there is an incident involving intimidation, vandalism, larceny, simple assault or other bodily injury, the law requires that the statistic be reported as a hate crime even though there is no requirement to report the crime classification in any other area of the compliance document.

A bias-related (hate) crime is not a separate, distinct crime, but is the commission of a criminal offense which was motivated by the offender's bias. For example, a subject assaults a victim, which is a crime. If the facts of the case indicate that the offender was motivated to commit the offense because of his bias against the victim's race, sexual orientation, etc... the assault is then also classified as a hate crime.

If a bias-related (hate) crime was reported to you that is not one of the general Clery offenses list above, then please check the type of crime below:

Larceny (motivated by bias)
Vandalism (motivated by bias)
Intimidation (motivated by bias)
Simple Assault (motivated by bias)

*Once you click "Submit" you will receive confirmation that the report has been submitted to Clery Reporting Officials. If you have trouble submitting this form, you can email your report directly to CleryReporting@hendrix.edu.