{"id":431,"date":"2021-09-10T20:12:42","date_gmt":"2021-09-10T20:12:42","guid":{"rendered":"https:\/\/offices.vassar.edu\/security\/?page_id=431"},"modified":"2024-01-02T16:19:08","modified_gmt":"2024-01-02T20:19:08","slug":"clery-act-crime-incident-report","status":"publish","type":"page","link":"https:\/\/offices.vassar.edu\/campus-safety\/forms\/clery-act-crime-incident-report\/","title":{"rendered":"Clery Act Crime Incident Report Form"},"content":{"rendered":"<!-- Inserted by Dropdownizer plugin. Forces video embeds contained in dropdowns to have a size --><style>.dropdownizer__dropdown iframe { width: 100% !important; height: 100% !important; }<\/style>\n<p><strong>Do not use this form for a crime in progress. Call 911 or the\u00a0Campus Response Center at\u00a0<a rel=\"noreferrer noopener\" href=\"tel:+18454377333\" target=\"_blank\"><\/a><a href=\"tel:+18454377333\"><a href=\"tel:+18454377333\">(845) 437-7333<\/a><\/a>.\u00a0<\/strong>The mailbox for this form is not checked live\u2014it is checked periodically during business hours.<\/p>\n\n\n\n                <div class='gf_browser_gecko gform_wrapper gravity-theme gform-theme--no-framework' data-form-theme='gravity-theme' data-form-index='0' id='gform_wrapper_5' style='display:none'><div id='gf_5' class='gform_anchor' tabindex='-1'><\/div><form method='post' enctype='multipart\/form-data' target='gform_ajax_frame_5' id='gform_5'  action='\/campus-safety\/wp-json\/wp\/v2\/pages\/431#gf_5' data-formid='5' novalidate>\n                        <div class='gform-body gform_body'><div id='gform_fields_5' class='gform_fields top_label form_sublabel_below description_below validation_below'><div id=\"field_5_4\" class=\"gfield gfield--type-date gfield--input-type-date gfield--input-type-datepicker gfield--datepicker-no-icon gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_hidden\"  ><div class=\"admin-hidden-markup\"><i class=\"gform-icon gform-icon--hidden\" aria-hidden=\"true\" title=\"This field is hidden when viewing the form\"><\/i><span>This field is hidden when viewing the form<\/span><\/div><label class='gfield_label gform-field-label' for='input_5_4'>Date<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_date'>\n                            <input name='input_4' id='input_5_4' type='text' value='05\/16\/2026' class='datepicker gform-datepicker mdy datepicker_no_icon gdatepicker-no-icon'   placeholder='mm\/dd\/yyyy' aria-describedby=\"input_5_4_date_format\" aria-invalid=\"false\" aria-required=\"true\"\/>\n                            <span id='input_5_4_date_format' class='screen-reader-text'>MM slash DD slash YYYY<\/span>\n                        <\/div>\n                        <input type='hidden' id='gforms_calendar_icon_input_5_4' class='gform_hidden' value='https:\/\/offices.vassar.edu\/campus-safety\/wp-content\/plugins\/gravityforms\/images\/datepicker\/datepicker.svg'\/><\/div><div id=\"field_5_1\" class=\"gfield gfield--type-html gfield--input-type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class=\"gfield_label\">Form prepared by:<\/label>\n<style type=\"text\/css\">.gf_indent { padding-left: 4em !important; }<\/style><\/div><fieldset id=\"field_5_2\" class=\"gfield gfield--type-name gfield--input-type-name gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Name<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_complex ginput_container ginput_container--name no_prefix has_first_name no_middle_name has_last_name no_suffix gf_name_has_2 ginput_container_name gform-grid-row' id='input_5_2'>\n                            \n                            <span id='input_5_2_3_container' class='name_first gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_2.3' id='input_5_2_3' value=''   aria-required='true'     \/>\n                                                    <label for='input_5_2_3' class='gform-field-label gform-field-label--type-sub '>First<\/label>\n                                                <\/span>\n                            \n                            <span id='input_5_2_6_container' class='name_last gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_2.6' id='input_5_2_6' value=''   aria-required='true'     \/>\n                                                    <label for='input_5_2_6' class='gform-field-label gform-field-label--type-sub '>Last<\/label>\n                                                <\/span>\n                            \n                        <\/div><\/fieldset><div id=\"field_5_3\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_5_3'>Title<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_3' id='input_5_3' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_5_47\" class=\"gfield gfield--type-date gfield--input-type-date gfield--input-type-datepicker gfield--datepicker-no-icon gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_5_47'>Date<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_date'>\n                            <input name='input_47' id='input_5_47' type='text' value='' class='datepicker gform-datepicker mdy datepicker_no_icon gdatepicker-no-icon'   placeholder='mm\/dd\/yyyy' aria-describedby=\"input_5_47_date_format\" aria-invalid=\"false\" aria-required=\"true\"\/>\n                            <span id='input_5_47_date_format' class='screen-reader-text'>MM slash DD slash YYYY<\/span>\n                        <\/div>\n                        <input type='hidden' id='gforms_calendar_icon_input_5_47' class='gform_hidden' value='https:\/\/offices.vassar.edu\/campus-safety\/wp-content\/plugins\/gravityforms\/images\/datepicker\/datepicker.svg'\/><\/div><div id=\"field_5_46\" class=\"gfield gfield--type-email gfield--input-type-email gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_5_46'>Email<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_email'>\n                            <input name='input_46' id='input_5_46' type='email' value='' class='medium'    aria-required=\"true\" aria-invalid=\"false\"  \/>\n                        <\/div><\/div><div id=\"field_5_40\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\"><\/h3><\/div><fieldset id=\"field_5_6\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gf_list_inline gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >2. Was this crime reported to Campus Safety or any Law Enforcement Agency?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_5_6'>\n\t\t\t<div class='gchoice gchoice_5_6_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_6' type='radio' value='Yes'  id='choice_5_6_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_5_6_0' id='label_5_6_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_5_6_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_6' type='radio' value='No'  id='choice_5_6_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_5_6_1' id='label_5_6_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_5_7\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gf_indent gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >If \u201cYes,\u201d to whom was it reported?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_5_7'><div class='gchoice gchoice_5_7_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_7.1' type='checkbox'  value='Vassar College Campus Safety'  id='choice_5_7_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_5_7_1' id='label_5_7_1' class='gform-field-label gform-field-label--type-inline'>Vassar College Campus Safety<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_5_7_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_7.2' type='checkbox'  value='Town of Poughkeepsie Police Department'  id='choice_5_7_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_5_7_2' id='label_5_7_2' class='gform-field-label gform-field-label--type-inline'>Town of Poughkeepsie Police Department<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_5_7_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_7.3' type='checkbox'  value='Other'  id='choice_5_7_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_5_7_3' id='label_5_7_3' class='gform-field-label gform-field-label--type-inline'>Other<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_5_8\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gf_indent gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_5_8'>Other<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_8' id='input_5_8' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_5_41\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\"><\/h3><\/div><fieldset id=\"field_5_10\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gf_list_inline gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >3. Was this crime reported to any other Campus Officials?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_5_10'>\n\t\t\t<div class='gchoice gchoice_5_10_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_10' type='radio' value='Yes'  id='choice_5_10_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_5_10_0' id='label_5_10_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_5_10_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_10' type='radio' value='No'  id='choice_5_10_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_5_10_1' id='label_5_10_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_5_11\" class=\"gfield gfield--type-text gfield--input-type-text gf_indent gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_5_11'>If \u201cYes,\u201d to whom was it reported?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_11' id='input_5_11' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_5_42\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\"><\/h3><\/div><fieldset id=\"field_5_13\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gf_list_inline gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >4a. Does the complainant wish to file a Campus Safety report?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_5_13'>\n\t\t\t<div class='gchoice gchoice_5_13_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_13' type='radio' value='Yes'  id='choice_5_13_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_5_13_0' id='label_5_13_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_5_13_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_13' type='radio' value='No'  id='choice_5_13_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_5_13_1' id='label_5_13_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_5_48\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gf_list_inline gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >4b. Does the complainant wish to file a Police report?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_5_48'>\n\t\t\t<div class='gchoice gchoice_5_48_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_48' type='radio' value='Yes'  id='choice_5_48_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_5_48_0' id='label_5_48_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_5_48_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_48' type='radio' value='No'  id='choice_5_48_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_5_48_1' id='label_5_48_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_5_15\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gf_indent gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_5_15'>Complainant Affiliation with Campus<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_15' id='input_5_15' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_5_14\" class=\"gfield gfield--type-name gfield--input-type-name gf_indent gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Complainant Name<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_complex ginput_container ginput_container--name no_prefix has_first_name no_middle_name has_last_name no_suffix gf_name_has_2 ginput_container_name gform-grid-row' id='input_5_14'>\n                            \n                            <span id='input_5_14_3_container' class='name_first gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_14.3' id='input_5_14_3' value=''   aria-required='true'     \/>\n                                                    <label for='input_5_14_3' class='gform-field-label gform-field-label--type-sub '>First<\/label>\n                                                <\/span>\n                            \n                            <span id='input_5_14_6_container' class='name_last gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_14.6' id='input_5_14_6' value=''   aria-required='true'     \/>\n                                                    <label for='input_5_14_6' class='gform-field-label gform-field-label--type-sub '>Last<\/label>\n                                                <\/span>\n                            \n                        <\/div><\/fieldset><fieldset id=\"field_5_16\" class=\"gfield gfield--type-address gfield--input-type-address gf_indent gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Complainant Address<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend>    \n                    <div class='ginput_complex ginput_container has_street has_street2 has_city has_state has_zip ginput_container_address gform-grid-row' id='input_5_16' >\n                         <span class='ginput_full address_line_1 ginput_address_line_1 gform-grid-col' id='input_5_16_1_container' >\n                                        <input type='text' name='input_16.1' id='input_5_16_1' value=''    aria-required='true'    \/>\n                                        <label for='input_5_16_1' id='input_5_16_1_label' class='gform-field-label gform-field-label--type-sub '>Street Address<\/label>\n                                    <\/span><span class='ginput_full address_line_2 ginput_address_line_2 gform-grid-col' id='input_5_16_2_container' >\n                                        <input type='text' name='input_16.2' id='input_5_16_2' value=''     aria-required='false'   \/>\n                                        <label for='input_5_16_2' id='input_5_16_2_label' class='gform-field-label gform-field-label--type-sub '>Address Line 2<\/label>\n                                    <\/span><span class='ginput_left address_city ginput_address_city gform-grid-col' id='input_5_16_3_container' >\n                                    <input type='text' name='input_16.3' id='input_5_16_3' value=''    aria-required='true'    \/>\n                                    <label for='input_5_16_3' id='input_5_16_3_label' class='gform-field-label gform-field-label--type-sub '>City<\/label>\n                                 <\/span><span class='ginput_right address_state ginput_address_state gform-grid-col' id='input_5_16_4_container' >\n                                        <select name='input_16.4' id='input_5_16_4'     aria-required='true'    ><option value='' selected='selected'><\/option><option value='Alabama' >Alabama<\/option><option value='Alaska' >Alaska<\/option><option value='American Samoa' >American Samoa<\/option><option value='Arizona' >Arizona<\/option><option value='Arkansas' >Arkansas<\/option><option value='California' >California<\/option><option value='Colorado' >Colorado<\/option><option value='Connecticut' >Connecticut<\/option><option value='Delaware' >Delaware<\/option><option value='District of Columbia' >District of Columbia<\/option><option value='Florida' >Florida<\/option><option value='Georgia' >Georgia<\/option><option value='Guam' >Guam<\/option><option value='Hawaii' >Hawaii<\/option><option value='Idaho' >Idaho<\/option><option value='Illinois' >Illinois<\/option><option value='Indiana' >Indiana<\/option><option value='Iowa' >Iowa<\/option><option value='Kansas' >Kansas<\/option><option value='Kentucky' >Kentucky<\/option><option value='Louisiana' >Louisiana<\/option><option value='Maine' >Maine<\/option><option value='Maryland' >Maryland<\/option><option value='Massachusetts' >Massachusetts<\/option><option value='Michigan' >Michigan<\/option><option value='Minnesota' >Minnesota<\/option><option value='Mississippi' >Mississippi<\/option><option value='Missouri' >Missouri<\/option><option value='Montana' >Montana<\/option><option value='Nebraska' >Nebraska<\/option><option value='Nevada' >Nevada<\/option><option value='New Hampshire' >New Hampshire<\/option><option value='New Jersey' >New Jersey<\/option><option value='New Mexico' >New Mexico<\/option><option value='New York' >New York<\/option><option value='North Carolina' >North Carolina<\/option><option value='North Dakota' >North Dakota<\/option><option value='Northern Mariana Islands' >Northern Mariana Islands<\/option><option value='Ohio' >Ohio<\/option><option value='Oklahoma' >Oklahoma<\/option><option value='Oregon' >Oregon<\/option><option value='Pennsylvania' >Pennsylvania<\/option><option value='Puerto Rico' >Puerto Rico<\/option><option value='Rhode Island' >Rhode Island<\/option><option value='South Carolina' >South Carolina<\/option><option value='South Dakota' >South Dakota<\/option><option value='Tennessee' >Tennessee<\/option><option value='Texas' >Texas<\/option><option value='Utah' >Utah<\/option><option value='U.S. Virgin Islands' >U.S. Virgin Islands<\/option><option value='Vermont' >Vermont<\/option><option value='Virginia' >Virginia<\/option><option value='Washington' >Washington<\/option><option value='West Virginia' >West Virginia<\/option><option value='Wisconsin' >Wisconsin<\/option><option value='Wyoming' >Wyoming<\/option><option value='Armed Forces Americas' >Armed Forces Americas<\/option><option value='Armed Forces Europe' >Armed Forces Europe<\/option><option value='Armed Forces Pacific' >Armed Forces Pacific<\/option><\/select>\n                                        <label for='input_5_16_4' id='input_5_16_4_label' class='gform-field-label gform-field-label--type-sub '>State<\/label>\n                                      <\/span><span class='ginput_left address_zip ginput_address_zip gform-grid-col' id='input_5_16_5_container' >\n                                    <input type='text' name='input_16.5' id='input_5_16_5' value=''    aria-required='true'    \/>\n                                    <label for='input_5_16_5' id='input_5_16_5_label' class='gform-field-label gform-field-label--type-sub '>ZIP Code<\/label>\n                                <\/span><input type='hidden' class='gform_hidden' name='input_16.6' id='input_5_16_6' value='United States' \/>\n                    <div class='gf_clear gf_clear_complex'><\/div>\n                <\/div><\/fieldset><div id=\"field_5_17\" class=\"gfield gfield--type-phone gfield--input-type-phone gf_indent gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_5_17'>Complainant Phone Number<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_phone'><input name='input_17' id='input_5_17' type='tel' value='' class='large'   aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_5_18\" class=\"gfield gfield--type-name gfield--input-type-name gf_indent field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Suspect Name<\/legend><div class='gfield_description' id='gfield_description_5_18'>(If complainant wishes to share)<\/div><div class='ginput_complex ginput_container ginput_container--name no_prefix has_first_name no_middle_name has_last_name no_suffix gf_name_has_2 ginput_container_name gform-grid-row' id='input_5_18'>\n                            \n                            <span id='input_5_18_3_container' class='name_first gform-grid-col gform-grid-col--size-auto' >\n                                                    <label for='input_5_18_3' class='gform-field-label gform-field-label--type-sub '>First<\/label>\n                                                    <input type='text' name='input_18.3' id='input_5_18_3' value=''   aria-required='false'     \/>\n                                                <\/span>\n                            \n                            <span id='input_5_18_6_container' class='name_last gform-grid-col gform-grid-col--size-auto' >\n                                                            <label for='input_5_18_6' class='gform-field-label gform-field-label--type-sub '>Last<\/label>\n                                                            <input type='text' name='input_18.6' id='input_5_18_6' value=''   aria-required='false'     \/>\n                                                        <\/span>\n                            \n                        <\/div><\/fieldset><div id=\"field_5_19\" class=\"gfield gfield--type-text gfield--input-type-text gf_indent field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_5_19'>Suspect Affiliation With Campus<\/label><div class='gfield_description' id='gfield_description_5_19'>(If complainant wishes to share)<\/div><div class='ginput_container ginput_container_text'><input name='input_19' id='input_5_19' type='text' value='' class='large'  aria-describedby=\"gfield_description_5_19\"    aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_5_44\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\"><\/h3><\/div><fieldset id=\"field_5_20\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gf_list_3col_vertical gfield_contains_required field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >5. Indicate the crime(s) reported. If unsure, provide a description of incident at bottom of form.<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_5_20'><div class='gchoice gchoice_5_20_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_20.1' type='checkbox'  value='Robbery'  id='choice_5_20_1'   aria-describedby=\"gfield_description_5_20\"\/>\n\t\t\t\t\t\t\t\t<label for='choice_5_20_1' id='label_5_20_1' class='gform-field-label gform-field-label--type-inline'>Robbery<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_5_20_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_20.2' type='checkbox'  value='Aggravated Assault'  id='choice_5_20_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_5_20_2' id='label_5_20_2' class='gform-field-label gform-field-label--type-inline'>Aggravated Assault<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_5_20_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_20.3' type='checkbox'  value='Burglary'  id='choice_5_20_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_5_20_3' id='label_5_20_3' class='gform-field-label gform-field-label--type-inline'>Burglary<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_5_20_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_20.4' type='checkbox'  value='Motor Vehicle Theft'  id='choice_5_20_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_5_20_4' id='label_5_20_4' class='gform-field-label gform-field-label--type-inline'>Motor Vehicle Theft<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_5_20_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_20.5' type='checkbox'  value='Arson'  id='choice_5_20_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_5_20_5' id='label_5_20_5' class='gform-field-label gform-field-label--type-inline'>Arson<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_5_20_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_20.6' type='checkbox'  value='Negligent Manslaughter'  id='choice_5_20_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_5_20_6' id='label_5_20_6' class='gform-field-label gform-field-label--type-inline'>Negligent Manslaughter<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_5_20_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_20.7' type='checkbox'  value='Murder including Non-negligent Manslaughter'  id='choice_5_20_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_5_20_7' id='label_5_20_7' class='gform-field-label gform-field-label--type-inline'>Murder including Non-negligent Manslaughter<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_5_20_8'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_20.8' type='checkbox'  value='Rape*'  id='choice_5_20_8'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_5_20_8' id='label_5_20_8' class='gform-field-label gform-field-label--type-inline'>Rape*<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_5_20_9'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_20.9' type='checkbox'  value='Fondling*'  id='choice_5_20_9'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_5_20_9' id='label_5_20_9' class='gform-field-label gform-field-label--type-inline'>Fondling*<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_5_20_11'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_20.11' type='checkbox'  value='Incest*'  id='choice_5_20_11'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_5_20_11' id='label_5_20_11' class='gform-field-label gform-field-label--type-inline'>Incest*<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_5_20_12'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_20.12' type='checkbox'  value='Statutory Rape*'  id='choice_5_20_12'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_5_20_12' id='label_5_20_12' class='gform-field-label gform-field-label--type-inline'>Statutory Rape*<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_5_20_13'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_20.13' type='checkbox'  value='Domestic Violence*'  id='choice_5_20_13'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_5_20_13' id='label_5_20_13' class='gform-field-label gform-field-label--type-inline'>Domestic Violence*<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_5_20_14'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_20.14' type='checkbox'  value='Dating Violence*'  id='choice_5_20_14'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_5_20_14' id='label_5_20_14' class='gform-field-label gform-field-label--type-inline'>Dating Violence*<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_5_20_15'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_20.15' type='checkbox'  value='Stalking*'  id='choice_5_20_15'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_5_20_15' id='label_5_20_15' class='gform-field-label gform-field-label--type-inline'>Stalking*<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_5_20_16'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_20.16' type='checkbox'  value='Illegal Weapons Possession**'  id='choice_5_20_16'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_5_20_16' id='label_5_20_16' class='gform-field-label gform-field-label--type-inline'>Illegal Weapons Possession**<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_5_20_17'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_20.17' type='checkbox'  value='Drug Law Violations**'  id='choice_5_20_17'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_5_20_17' id='label_5_20_17' class='gform-field-label gform-field-label--type-inline'>Drug Law Violations**<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_5_20_18'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_20.18' type='checkbox'  value='Liquor Law Violations**'  id='choice_5_20_18'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_5_20_18' id='label_5_20_18' class='gform-field-label gform-field-label--type-inline'>Liquor Law Violations**<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_5_20_19'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_20.19' type='checkbox'  value='Hazing'  id='choice_5_20_19'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_5_20_19' id='label_5_20_19' class='gform-field-label gform-field-label--type-inline'>Hazing<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><div class='gfield_description' id='gfield_description_5_20'>* If reported to Title IX this report is not mandatory<br>\n** Report only if arrest or student conduct action taken\n<\/div><\/fieldset><div id=\"field_5_21\" class=\"gfield gfield--type-html gfield--input-type-html gfield_description gfield_html gfield_html_formatted field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><p><strong>Note: <\/strong> Definitions for crimes are listed on the <a href=\"\/campus-safety\/statistics\/definitions\/\" target=\"_blank\"><i>Clery Crime Definitions reference sheet<\/i><\/a>. <\/p><\/div><fieldset id=\"field_5_22\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gf_list_inline gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Was the crime indicated above a hate crime?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_5_22'>\n\t\t\t<div class='gchoice gchoice_5_22_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_22' type='radio' value='Yes'  id='choice_5_22_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_5_22_0' id='label_5_22_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_5_22_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_22' type='radio' value='No'  id='choice_5_22_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_5_22_1' id='label_5_22_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_5_23\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gf_list_inline gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Was the crime reported a hate crime (not listed above) which involved bodily injury, simple assault, intimidation, larceny-theft of property OR destruction\/damage\/vandalism of property?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_5_23'>\n\t\t\t<div class='gchoice gchoice_5_23_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_23' type='radio' value='Yes'  id='choice_5_23_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_5_23_0' id='label_5_23_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_5_23_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_23' type='radio' value='No'  id='choice_5_23_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_5_23_1' id='label_5_23_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_5_24\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gf_indent gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_5_24'>If \u201cYes,\u201d give a brief explanation:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_24' id='input_5_24' class='textarea small'     aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><div id=\"field_5_45\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\"><\/h3><\/div><div id=\"field_5_26\" class=\"gfield gfield--type-html gfield--input-type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class=\"gfield_label\">6. Crime occurred:<\/label><\/div><div id=\"field_5_27\" class=\"gfield gfield--type-date gfield--input-type-date gfield--input-type-datepicker gfield--datepicker-no-icon gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_5_27'>Date<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_date'>\n                            <input name='input_27' id='input_5_27' type='text' value='' class='datepicker gform-datepicker mdy datepicker_no_icon gdatepicker-no-icon'   placeholder='mm\/dd\/yyyy' aria-describedby=\"input_5_27_date_format\" aria-invalid=\"false\" aria-required=\"true\"\/>\n                            <span id='input_5_27_date_format' class='screen-reader-text'>MM slash DD slash YYYY<\/span>\n                        <\/div>\n                        <input type='hidden' id='gforms_calendar_icon_input_5_27' class='gform_hidden' value='https:\/\/offices.vassar.edu\/campus-safety\/wp-content\/plugins\/gravityforms\/images\/datepicker\/datepicker.svg'\/><\/div><fieldset id=\"field_5_28\" class=\"gfield gfield--type-time gfield--input-type-time gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Time<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class=\"ginput_container ginput_complex gform-grid-row\">\n                        <div class='gfield_time_hour ginput_container ginput_container_time gform-grid-col' id='input_5_28'>\n                            <input type='number' name='input_28[]' id='input_5_28_1' value=''  min='0' max='12' step='1'  placeholder='HH' aria-required='true'   \/> \n                            <label class='gform-field-label gform-field-label--type-sub hour_label screen-reader-text' for='input_5_28_1'>Hours<\/label>\n                        <\/div>\n                        <div class=\"below hour_minute_colon gform-grid-col\">:<\/div>\n                        <div class='gfield_time_minute ginput_container ginput_container_time gform-grid-col'>\n                            <input type='number' name='input_28[]' id='input_5_28_2' value=''  min='0' max='59' step='1'  placeholder='MM' aria-required='true'  \/>\n                            <label class='gform-field-label gform-field-label--type-sub minute_label screen-reader-text' for='input_5_28_2'>Minutes<\/label>\n                        <\/div>\n                        <div class='gfield_time_ampm ginput_container ginput_container_time below gform-grid-col' >\n                                \n                                <select name='input_28[]' id='input_5_28_3'  >\n                                    <option value='am' >AM<\/option>\n                                    <option value='pm' >PM<\/option>\n                                <\/select> \n                                <label class='gform-field-label gform-field-label--type-sub am_pm_label screen-reader-text' for='input_5_28_3'>AM\/PM<\/label>                                \n                           <\/div>\n                    <\/div><\/fieldset><fieldset id=\"field_5_37\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Location:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_5_37'>\n\t\t\t<div class='gchoice gchoice_5_37_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_37' type='radio' value='Residence Hall'  id='choice_5_37_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_5_37_0' id='label_5_37_0' class='gform-field-label gform-field-label--type-inline'>Residence Hall<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_5_37_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_37' type='radio' value='Other On-campus (Academic Bldg., Bookstore, Grounds, etc.)'  id='choice_5_37_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_5_37_1' id='label_5_37_1' class='gform-field-label gform-field-label--type-inline'>Other On-campus (Academic Bldg., Bookstore, Grounds, etc.)<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_5_37_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_37' type='radio' value='Non-campus Facility 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