Rowan University Campus Security Authority (CSA) Reporting Form 

If this incident requires an immediate Public Safety response, (for example crime in progress/emergency situation) dial 911 or 256-4911.

This form is to be used by identified Campus Security Authorities-CSAs who are required under the Federal Clery Act to report information they receive about crimes. The information collected from these forms will be used to compile required reporting statistics to be included in the University’s Annual Security and Fire Safety Report and Daily Crime Log as required by law.

Rowan Public Safety personnel evaluate each CSA report to determine if the incident reported requires the publication of a Rowan Timely Warning or other mass notification to the campus community.

The intent of a Rowan Timely Warning or Rowan Alert is to enable members of the campus community to protect themselves and aid in the prevention of similar crimes. It is critical that pertinent information is provided as soon as it is available.

Please provide as much information as possible on this CSA report. However, the inclusion of personally identifiable information (complainant’s name, suspect’s name, etc.) is not required, but the inclusion of such information, if known, may assist the University in providing services and eliminating the possibility of double-counting incidents.

The University makes many resources available to victims, survivors and witnesses of crime at no cost. Some information regarding resources can be found at https://sites.rowan.edu/osec/titles/ix/resources/. If you have questions about this form or would like assistance completing this form, please contact the Clery Compliance office at 856-256-4562 or by email at cleryact@rowan.edu.

FORM USE
This form is used to gather statistical information to aid the University in compiling required statistics related to crimes that occur on campus and other University owned or controlled property. The collection of this information is required by the Clery Act. This is not a report for the purpose of initiating a criminal investigation. However, Rowan Public Safety personnel will review this information to evaluate crime trends and to determine whether the circumstances reported require the issuance of a mass notification to the campus community.

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Email *
CSA Contact Info
Person completing this form.
Your Name *
Your Phone Number *
Your Department
Date Incident Occurred
Please provide the date the crime occurred. If the date is not known, please provide a time frame.
Incident Date Known?
Clear selection
If an exact date is not known, please provide an approximate time frame. (Example: Fall 2024)
Date Incident Reported or Became Known to CSA
 *
MM
/
DD
/
YYYY
Incident Information
Brief description of the incident *
Has this incident been reported to another University office?
Clear selection
Check the best answer to the following questions:
Clery statistics group incidents based on the location where the event occurred. Locations are categorized as follows: On campus; On campus student housing; On public property (state roads or sidewalks running through campus), and on non-campus property (property that is owned or controlled by the University but not part of the main campus).
Campus (Best associated with this incident) 
 *
Pick the choice that best describes the location where the incident occurred. Please provide additional information in the description field below. *
Location Description
Did the incident occur at a University-sponsored activity or event?
Clear selection
Classification
Please choose the best classification based on your knowledge of the incident. Definitions can be found below.
Clery Act Offenses (Definitions below)
Clear selection
Sex Offenses (Definitions below)
Clear selection
VAWA Offenses
Clear selection
Hate Crimes  
Any of these or the above listed crimes that include some evidence that the offender was motivated by bias or hate toward a particular class of person or people. The type of bias should be indicated in the "Additional information" section below.
Clear selection
What type of hate crime?
Clear selection
Was the victim that told they can report this incident to Rowan Public Safety?
Clear selection
Does the victim wish to have Public Safety involvement?
Clear selection
Does the victim understand that they may contact Public Safety at any time if they change their mind?
Clear selection
Additional Information
If there are any other details about this event you would like to share, you may do so here.
Clery Crime Definitions

Murder/Non-Negligent Manslaughter: the willful (non-negligent) killing of one human being by another.  

Manslaughter by Negligence: the killing of another person through gross negligence.  

Robbery: the taking or attempting to take anything of value from the care, custody, or control of a person or persons by force or threat of force or violence and/or by putting the victim in fear.

Sexual assaults (sex offenses): any sexual act directed against another person, without consent of the victim, including instances where the victim is incapable of giving consent. Includes attempted sexual assaults.

Rape: the penetration, no matter how slight, of the vagina or anus, with any body part or object, or oral penetration by a sex organ of another person, without the consent of the victim. This offense includes the rape of both males and females.

Fondling: the touching of the private body parts of another person for the purpose of sexual gratification, without the consent of the victim, including instances where the victim is incapable of giving consent because of his/her age or because of his/her temporary or permanent mental incapacity.

Incest: sexual intercourse between persons who are related to each other within the degrees wherein marriage is prohibited by law.

Statutory Rape: sexual intercourse with a person who is under the statutory age of consent. The age of consent in New Jersey is 16 years old, with certain exceptions.

Aggravated Assault: an unlawful attack by one person upon another for the purpose of inflicting severe or aggravated bodily injury. This type of assault usually is accompanied by the use of a weapon or by means likely to produce death or great bodily harm. 

Burglary: the unlawful entry of a structure to commit a felony or a theft. A structure is defined as having four walls, a roof and a door.

Motor vehicle theft: the theft or attempted theft of a motor vehicle.

Arson: any willful or malicious burning or attempt to burn, with or without intent to defraud, a dwelling house, public building, motor vehicle or aircraft, personal property of another, etc.

Hate Crimes (above listed plus 4 below): a criminal offense that manifests evidence that the victim was intentionally selected because of the perpetrator’s bias against the victim. The following eight categories are reported:  race, gender, gender identity, sexual orientation, religion, ethnicity, national origin or disability.

  • Larceny/Theft: the unlawful taking, carrying, leading or riding away of property from the possession or constructive possession of another. Constructive possession is the condition in which a person does not have physical custody or possession, but is in a position to exercise dominion or control over a thing.
  • Simple Assault: an unlawful physical attack by one person upon another where neither the offender displays a weapon, nor the victim suffers obvious severe or aggravated bodily injury involving apparent broken bones, loss of teeth, possible internal injury, severe laceration, or loss of consciousness.
  • Intimidation: to unlawfully place another person in reasonable fear of bodily harm through the use of threatening words and/or other conduct, but without displaying a weapon or subjecting the victim to actual physical attack.
  • Destruction/Damage/Vandalism of Property: to willfully or maliciously destroy, damage, deface or otherwise injure real or personal property without the consent of the owner or the person having custody or control of it.

Dating Violence: violence committed by a person who is or has been in a social relationship of a romantic or intimate nature with the victim. The existence of such a relationship shall be determined based on the reporting party’s statement and with consideration of the length of the relationship, the type of relationship and the frequency of interaction between the persons involved in the relationship.

Domestic Violence: a felony or misdemeanor crime of violence committed by:

  • a current or former spouse or intimate partner of the victim,
  • a person with whom the victim shares a child in common,
  • a person who is cohabitating with, or has cohabitated with, the victim as a spouse or intimate partner,
  • a person similarly situated to a spouse of the victim under the domestic or family violence laws of the jurisdiction in which the crime of violence occurred,
  • any other person against an adult or youth victim who is protected from that person’s acts under the domestic or family violence laws of the jurisdiction in which the crime of violence occurred.
  • consistent with New Jersey law, roommate-involved incidents.

Stalking: engaging in a course of conduct directed at a specific person that would cause a reasonable person to fear for the person’s safety or the safety of others; or suffer substantial emotional distress.

  • Course of conduct means two or more acts, including, but not limited to, acts in which the stalker directly, indirectly, or through third parties, by any action, method, device, or means, follows, monitors, observes, surveils, threatens, or communicates to or about a person, or interferes with a person’s property.
  • Reasonable person means a reasonable person under similar circumstances and with similar identities of the victim
  • Substantial emotional distress means significant mental suffering or anguish that may, but does not necessarily require medical or other professional treatment or counseling.

Weapons Law Violations: the violation of laws or ordinances prohibiting the manufacture, sale, purchase, transportation, possession, concealment, or use of firearms, cutting instruments, explosives, incendiary devices or other deadly weapons. This classification encompasses weapons offenses that are regulatory in nature.

Drug Law Violations: the violation of laws prohibiting the production, distribution and/or use of certain controlled substances and the equipment or devices utilized in their preparation and/or use. The unlawful cultivation, manufacture, distribution, sale, purchase, use, possession, transportation or importation of any controlled drug or narcotic substance.

Liquor Law Violations: the violation of state or local laws or ordinances prohibiting the manufacture, sale, purchase, transportation, possession or use of alcoholic beverages, not including driving under the influence and drunkenness.

Thank you for taking the time to provide this information. If you have any questions regarding this submission, please contact the Clery Compliance Office (856) 256-4562 or by email at cleryact@rowan.edu.
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