Police Division

Anonymous Reporting

This form allows you to contact the Coastal Carolina University Department of Public Safety with information regarding;

• crimes,
• undesirable or suspicious activity
• on the campus
• at the Residence Halls
• at University Place

The form will be e-mailed anonymously directly to the Investigations Division of the Department.

All information will be treated confidentially.

1. What type of crime:
   
2. Where did the crime or activity occur (please be specific):
   
   
3. Date(s) of crime or activity:
   
   
4. Time(s) of crime or activity:
   
   
5. Suspect(s) name(s):
   
   
6. Suspect(s) description(s):
   
   
7. Suspect vehicle description and license tag number, if known:
   
   
8. Submit any other information that you believe is important:
   
   
9. If you want to be contacted, please enter your name, e-mail address and telephone number (otherwise all information will be submitted anonymously)
   
   

   Name:
   E-mail:
   Telephone:	(xxx) xxx-xxxx

Please enter the Anti-Spam verification code exactly how you see it below: