This form is solely for the purpose of collecting data for statistical reporting required by the Crime Awareness and Campus Security Act, as amended by the Higher Education Amendments of 1998.
Please fill out the secure web-based form below. You also have the option to print the crime reporting form and submit this form in person at the Division of Public Safety, 4040 Chestnut Street, send via email to firstname.lastname@example.org, or via fax to 215-573-7042.
You may contact Penn Police at any time by visiting department headquarters at 4040 Chestnut Street, calling 215-573-3333 or 511 from any campus phone, or by using one of the many Bluelight and emergency telephones located throughout the campus.
For more on Clery reporting visit www.publicsafety.upenn.edu/clery or call Penn’s Division of Public Safety’s Special Services Department at 215-898-4481 (898-6600 off-hours).
This form is to be completed by University officials with significant responsibility for student and campus activities.
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