For emergencies please call 562.985.4101 or dial 911. Date of incident: * Year Year201620172018201920202021 Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 Location of incident: * Please provide a description of the incident: * Suspect(s) name and/or description (if known): Suspect status at CSULB: * Student Staff/Faculty/Administrator Other/Not Sure Is there an imminent threat to your safety or the safety of someone else? * Yes (If yes, please contact UPD immediately at 562.985.4101 or 911) No Unsure May we contact you if we need additional information? * Yes No If yes, please provide your contact information below. A detective will review the details of the incident and contact you shortly. Your name: Campus status: Student Staff/Faculty/Administrator Other Campus ID # (if applicable): Telephone number: Email address:
