Administrative Forms

You may need the following forms to gain proper access to buildings or report incidents on campus.

Campus Security Authorities Incident Report Form

This form should be completed by those individuals identified as “Campus Security Authorities” who are required to report information they receive about specified crimes pursuant to the Federal Clery Act. The information collected will be used to prepare a compilation of statistical information that will be included in the campus Annual Security Report.

It is the policy of Clarion University to ensure that victims and witnesses to crimes are aware of their rights to report criminal acts to the police and to report University Regulations violations to Judicial Mediations. However, if a reporting person requests anonymity, this request must be honored to the extent permitted by law. Accordingly, no information should be included on this form that would personally identify the victim without his or her consent. Completed form should be forwarded by Campus Security Authorities to Public Safety in either printed or electronic form.

Campus Security Authorities Incident Report Form

Building authorization

Please complete the Building Authorization Form including student ID numbers.  Print the completed form and have it signed by the proper authorities.  Return the form to Public Safety.  Students will not be allowed to enter any rooms without proper authorization and identification.  Entrance will be granted from 6 a.m. until 10 p.m.  Special circumstances will be evaluated and authorized by the Chief of University Police.

Building Authorization Form

Access and Key Control

The University Police Department is responsible for granting access to academic buildings with card-swipe readers.  At the present time, the Science & Technology Center has card reader access for exterior doors and specific interior doors.  Access is requested by the professor and authorized by the department chair and dean, then forwarded to campus police to be processed. 

Campus keys are distributed through the office of Public Safety. Key requests forms must be completed by the employee or student requesting key access to campus buildings or offices. The request is approved by the University Police department.

Once the keys have been made by the locksmith, the keys are issued through Public Safety. All keys must be signed for and are the responsibility of the individuals who receive them.

All keys must be returned to public safety at the end of the authorized time period. Lost keys must be reported immediately to Public Safety and a charge of $40 per key will be assessed to the responsible individual. Lost key fees must be paid prior to re-issuance of keys.

Additional charges may be assessed as determined by the Chief of Police and the Facilities management department if the loss indicates a security breach that would require the re-keying of an entire building.

 Key Request Form (printable form)

Campus accidents

Please complete this form for any accident or incident occurring on University Property for which a claim may or may not be filed at the present or in the near future.  All accidents or incidents occurring on campus must be investigated by the university Police or the campus Safety Inspector.  No claim can be submitted to Bureau of Risk and Insurance Management without a police report and a completed accident report. Please contact +1 814 393 2111 to report an accident or incident.

Campus Accident Report Form for BRIM


Safety Referral

Last Updated 3/4/20