Campus Security Authority Crime Report Form

In order to help maintain a campus and workplace environment that is safe for all students, faculty, staff, and visitors Middlebury College encourages all members of the campus community to immediately report crimes or suspicious activity to the Middlebury College Department of Public Safety. For emergencies dial 911 or call Public Safety at 802-443-5911. Crimes and suspicious activity may be reported by filling out the form below or by contacting Public Safety (via telephone, email, or in person). Contact information is available here.

Pursuant to the Clery Act, a federal law, Middlebury College is required to, among other things, compile and publish certain crime statistics in an Annual Security Report. As part of this obligation, members of the College community who are considered to be Campus Security Authorities are required to report Clery crimes to the Department of Public Safety. To report a crime, please use the online form below (please also call Public Safety or dial 911 if an emergency). The reported crime statistics will be included in Middlebury’s Annual Security Report, and crime reports will be recorded in the Department of Public Safety’s Daily Crime Log. These reports are anonymous, which means that Middlebury will not disclose the names of complainants or other personally identifying information.

If an incident of sexual misconduct, domestic violence, dating violence or stalking is reported to you please fill out the online form below and immediately notify a Judicial Affairs Officer, Human Relations Officer, or the Title IX Coordinator. If you need immediate assistance contact Public Safety at 802.443.5911 or dial 911.

When you submit this form, it will be electronically transmitted to the Director of Public Safety and the Title IX Coordinator. The information will be reviewed and a determination will be made as to whether the incident warrants the issuance of a timely warning/emergency notification to the Middlebury College community and whether it’s a reportable crime. (Timely Warnings/Emergency Notifications do not contain information that could identify the victim.)

Definitions of Clery crimes are listed here. For information about Middlebury Campus Security Authorities, reporting obligations, and resources, see Campus Security Authorities and the Annual Security and Fire Safety Report.

 
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Enter the date range of the incident(s) you are reporting (mm/dd/yy to mm/dd/yy). If the date is unknown, type in "Unknown.)
Please provide specific, detailed information related to the reported incident(s).
If known, provide specific occurrence location (building name, street address, residence hall name, dorm room number, office number, etc.).
Was the crime reported to you by the victim, a third party, or both?
If, to your knowledge, a law enforcement agency was notified, please enter the name of that agency.
If another department was notified by the victim, the third party or yourself, please indicate the name of the department(s) below.