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Notice Regarding Collection, Use, and Disclosure of Personal Information by the University
If you provide your personal information, it will be used by the University for the purpose of investigating the suspicious activity or crime, and for communication. This information is being collected under the authority of The University of Manitoba Act and will not be used or disclosed for other purposes, unless permitted by The Freedom of Information and Protection of Privacy Act (FIPPA). If you have any questions about the collection of your personal information, contact the Access & Privacy Office (tel. 204-474-9462), 233 Elizabeth Dafoe Library, University of Manitoba, Winnipeg, MB, R3T 2N2.
 

1. Date of incident:
 

mm/dd/yyyy
 Calendar
 
2. Time of incident: Please approximate if you are unsure of the time.
 

 
3. Location of incident:
 

 
4. Describe in detail the nature of the crime/event.  (Please provide as much information as possible, including names and/or description of person(s) involved, vehicle(s) involved, licence plates, etc).
 

 
5. Were you a victim in this incident?
 

 
 
6. Contact Information:  In the event that further information is required, Security Services may need to contact you.  If you would like to be contacted, please include your contact information below.  If you do not wish to be contacted, please omit this section and click SUMBIT to complete your report.