Incident Report Form

To report an incident to the Chief of Police, please fill in the information below and click on the submit form button. Click on the reset form button to clear the information entered into the form. Contact information is not required.

All information will be kept CONFIDENTIAL!

Incident Report (Items in bold are required)
Select Level of Privacy	Full Name

Email Address	Phone Number

Date of Incident	Time of Incident	Location of Incident

Name of Officer

Comments

Enter the following number and text color for form verification

Click one of the following links:

Clery Act

Links to Useful Information

Contact the Campus Police:

Department of Campus Police
Central VA Community College
3506 Wards Rd.
Lynchburg VA 24502

Telephone: 434.832.7700

Located in Amherst Hall, Room 2120