From date*  (dd/mm/yyyy) From time*  (hh:mm)

To date*   (dd/mm/yyyy) To time*  (hh:mm)

General details

Location:*

Location (if other): -- select a location -- 1E 1S 1W 1WN 2E 2S 2W 3E 3S 3W 3WN 4E 4S 4S Annexe 5W 6E 6W 7W 8W 9W Accomm. Services Art Barn Centre Bankside Brendon Court Bus Terminus Car Park A Car Park B Car Park C Car Park D Car Park E Car Park F Car Park G Car Park J Car Park K Car Park L Car Park W Carpenter House Central Stores Chaplaincy Chaplain's House Choices Claverton Rooms Clevelands and Canal Wharf Conygre House Eastwood Elements Nightclub Estates Esther Parkin John Wood Library Marlborough Court Medical Centre Mendip Terrace Norwood Osborne House Parade Bar PO/Bank Polden Court Pulteney Court Quantock Terrace Solsbury Court Sports Hall Student Accomm. Office Student Union Student Union Bar Student Union Elements STV Changing Rooms STV Other Sulis Club Swimming Pool 25 metre Swindon The Parade Thornbank UBSA Underdeck University Hall Wessex House Westwood Conygre Westwood Cotswold Westwood Derhill Westwood Mendip Westwood Quantock Westwood Quarry Westwood Wolfson Other - please specify below

Incident* -- select an incident -- Anti-Social Behaviour Assault Bomb Alert Burglary Criminal Damage Drink Spiking Fire - Accidental Fire - Arson Flood Gas Leak Power Failure Road Traffic Collision Skateboarding Suspicious Package Theft Theft of a Motor Vehicle

Victim's details (or informant's details if University of Bath is the loser)

Family name: Other names

Tel number Mobile number

Gender* Male 
Female Email address*

Address Department

Victim* Staff 
Student 
Visitor
University Injury* Minor 
Serious 
Hospitalisation
Not applicable

Property/incident details

Property details to include any serial number or other identifying mark

Property value Owner* Personal
University

Reported to Police * No
Yes Crime number