CSA Report Form

Campus Security Authority Report Form

College employees who have responsibilities outside of the academic classroom for student and campus activities, including but not limited to student housing, student discipline, and judicial proceedings, may be designated as a Campus Security Authority. A CSA has responsibility to report is subject to Green River’s Crime Reporting Policy.

CSAs may include but are not limited to:

• Deans, Directors, Department Heads, Supervisors
• Faculty and Academic Advisers
• Running Start Advisers
• Campus Corner Apartments staff
• Human Resources staff
• Atheltic staff inlcuding coaches and staff
• Campus Life staff
• Green River Safety Officers

The Green River Crime Reporting Policy requires each Campus Security Authority to report to Green River College Campus Safety when he or she becomes aware of information that indicates that a Clery Act incident may have occurred. Clery Act incidents include sex offenses, robbery, other violent crimes, such as dating and domestic violence, drug abuse violations and liquor law violations that result in either an arrest or a disciplinary referral, and any crime considered to be motivated by hate or bias. To report such a crime or crimes, please fill out the form below.

Your submission will be reviewed by Campus Safety and investigated. Appropriate action will be taken. Typically you will not receive a reply. If you have questions or concerns contact the Director of Campus Safety at (253) 288-3335.