{"id":14914,"date":"2017-01-23T15:55:01","date_gmt":"2017-01-23T15:55:01","guid":{"rendered":"https:\/\/www.highpoint.edu\/safety\/?page_id=14914"},"modified":"2023-06-09T08:39:11","modified_gmt":"2023-06-09T12:39:11","slug":"crime-incident-reporting-form","status":"publish","type":"page","link":"https:\/\/www.highpoint.edu\/safety\/crime-incident-reporting-form\/","title":{"rendered":"Crime and Incident Reporting Form"},"content":{"rendered":"<p><a href=\"https:\/\/www.highpoint.edu\/safety\/crime-incident-reporting-form\/security\/\" rel=\"attachment wp-att-14917\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-full wp-image-14917\" src=\"https:\/\/www.highpoint.edu\/safety\/files\/2017\/01\/security.png\" alt=\"security\" width=\"123\" height=\"141\" \/><\/a>According to the Higher Education Act, or 20 U.S.C. 1902, now known as the Jeanne Clery Disclosure of Campus Security Policy and Campus Crime Statistics Act, High Point University, is required to collect and annually publish statistics concerning the occurrence of selected crimes on campus property (including residential facilities), non-campus property, and public property, recorded or known to High Point University Security, local law enforcement agencies or any individuals identified by the University as \u201cCampus Security Authorities\u201d (CSA). Campus Security Authorities are defined as, \u201can official of an institution who has significant responsibility for student and campus activities, including but not limited to, student housing, student discipline, and campus judicial procedures.\u201d The information collected from these forms is used to prepare a compilation of statistical crime information for inclusion in the campus\u2019 Annual Security Report.\u00a0 High Point University Security will use this form to determine the category of the crime or incident and the location under which the incident should be reported according to the requirements of the Clery Act.\u00a0 Data collected on this form is to be used to promote crime awareness and enhance campus safety.<\/p>\n<p>It is the policy of High Point University to ensure that victims and witnesses to crime are aware of their right to report criminal acts to HPU Security or to the police, and to report University policy violations to the appropriate office.\u00a0 However, if a reporting person requests anonymity, this request must be honored to the extent permitted by law.\u00a0 Accordingly, no information should be included on this form that would personally identify the victim without his\/her consent.<\/p>\n<p>As a CSA for High Point University please follow the guidelines set forth by your department for reporting one of the Clery Act specified crimes.\u00a0 A person reporting a specified crimes\/incident to a CSA shall also be encouraged to report the crime to High Point University Security and local law enforcement agencies.<\/p>\n<p>CSAs must also follow High Point University Policy by completing the Crime &amp; Incident Reporting Form at the end of the year advising if a specified crime was reported to them but forgot to report it.<\/p>\n<hr \/>\n<h2><strong><u>Procedures:<\/u><\/strong><\/h2>\n<h5>If you are one of High Point University\u2019s CSAs and you receive a report or otherwise become aware of the occurrence of a Clery-reportable incident, please do the following:<\/h5>\n<ol>\n<li>\n<p style=\"text-align: left;\">Encourage the crime victim(s) and\/or witness to report the incident to HPU Security or local law enforcement.<\/p>\n<\/li>\n<li style=\"text-align: left;\">If the incident indicates the possibility of an imminent community threat, inform High Point University Security without delay.<\/li>\n<li style=\"text-align: left;\">If the incident reported is a sexual assault or other violent crime:\n<ul>\n<li>Inform the victim(s) and\/or witnesses to contact the <a href=\"mailto:titleix@highpoint.edu\">Title IX Director<\/a> (336-841-9138) and\/or HPU Security (336-841-9112, option 4).<\/li>\n<\/ul>\n<\/li>\n<li>\n<p style=\"text-align: left;\">Complete the Crime &amp; Incident Report form below.<\/p>\n<\/li>\n<\/ol>\n<h5><strong><em>If you have any questions concerning this form, please call 336-841-9085.<\/em><\/strong><\/h5>\n<hr \/>\n<p>&nbsp;<\/p>\n<script type=\"text\/javascript\">\n\/* <![CDATA[ *\/\nvar gform;gform||(document.addEventListener(\"gform_main_scripts_loaded\",function(){gform.scriptsLoaded=!0}),document.addEventListener(\"gform\/theme\/scripts_loaded\",function(){gform.themeScriptsLoaded=!0}),window.addEventListener(\"DOMContentLoaded\",function(){gform.domLoaded=!0}),gform={domLoaded:!1,scriptsLoaded:!1,themeScriptsLoaded:!1,isFormEditor:()=>\"function\"==typeof InitializeEditor,callIfLoaded:function(o){return!(!gform.domLoaded||!gform.scriptsLoaded||!gform.themeScriptsLoaded&&!gform.isFormEditor()||(gform.isFormEditor()&&console.warn(\"The use of gform.initializeOnLoaded() is deprecated in the form editor context and will be removed in Gravity Forms 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d=gform.hooks[o][r];null==n&&(n=r+\"_\"+d.length),gform.hooks[o][r].push({tag:n,callable:e,priority:t=null==t?10:t})},doHook:function(r,o,e){var t;if(e=Array.prototype.slice.call(e,1),null!=gform.hooks[r][o]&&((o=gform.hooks[r][o]).sort(function(o,r){return o.priority-r.priority}),o.forEach(function(o){\"function\"!=typeof(t=o.callable)&&(t=window[t]),\"action\"==r?t.apply(null,e):e[0]=t.apply(null,e)})),\"filter\"==r)return e[0]},removeHook:function(o,r,t,n){var e;null!=gform.hooks[o][r]&&(e=(e=gform.hooks[o][r]).filter(function(o,r,e){return!!(null!=n&&n!=o.tag||null!=t&&t!=o.priority)}),gform.hooks[o][r]=e)}});\n\/* ]]> *\/\n<\/script>\n\n                <div class='gf_browser_gecko gform_wrapper gform_legacy_markup_wrapper gform-theme--no-framework' data-form-theme='legacy' data-form-index='0' id='gform_wrapper_5' style='display:none'>\n                        <div class='gform_heading'>\n                            <h3 class=\"gform_title\">Campus Security Authorities (CSA) Crime & Incident Report Form<\/h3>\n                            <p class='gform_description'>This form is to be used by CSAs to report Clery crimes, including but not limited to: homicide, sexual assault, robbery, aggravated assault, burglary, motor vehicle theft, arson, and hate crimes.<\/p>\n                        <\/div><form method='post' enctype='multipart\/form-data'  id='gform_5'  action='\/safety\/wp-json\/wp\/v2\/pages\/14914' data-formid='5' novalidate>\n                        <div class='gform-body gform_body'><ul id='gform_fields_5' class='gform_fields top_label form_sublabel_below description_below validation_below'><li id=\"field_5_29\" class=\"gfield gfield--type-honeypot gform_validation_container field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_5_29'>Name<\/label><div class='ginput_container'><input name='input_29' id='input_5_29' type='text' value='' autocomplete='new-password'\/><\/div><div class='gfield_description' id='gfield_description_5_29'>This field is for validation purposes and should be left unchanged.<\/div><\/li><li id=\"field_5_27\" class=\"gfield gfield--type-checkbox gfield--type-choice 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 gfield_label_before_complex' >Do you have any Clery incidents to report?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_checkbox'><ul class='gfield_checkbox' id='input_5_27'><li class='gchoice gchoice_5_27_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_27.1' type='checkbox'  value='YES'  id='choice_5_27_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_5_27_1' id='label_5_27_1' class='gform-field-label gform-field-label--type-inline'>YES<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_5_27_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_27.2' type='checkbox'  value='NO'  id='choice_5_27_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_5_27_2' id='label_5_27_2' class='gform-field-label gform-field-label--type-inline'>NO<\/label>\n\t\t\t\t\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_5_1\" class=\"gfield gfield--type-text 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_1'>Name (of person submitting this form):<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_1' id='input_5_1' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_5_2\" class=\"gfield gfield--type-text 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_2'>Department<\/label><div class='ginput_container ginput_container_text'><input name='input_2' id='input_5_2' type='text' value='' class='medium'      aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_5_5\" class=\"gfield gfield--type-text 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_5'>Position:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_5' id='input_5_5' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_5_28\" class=\"gfield gfield--type-captcha 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_28'>CAPTCHA<\/label><div id='input_5_28' class='ginput_container ginput_recaptcha' data-sitekey='6Lf_DRoUAAAAAPTCtpLn5klV-b1rn63O54ILHlLi'  data-theme='light' data-tabindex='0'  data-badge=''><\/div><\/li><li id=\"field_5_6\" class=\"gfield gfield--type-text 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_6'>Phone Number:<\/label><div class='ginput_container ginput_container_text'><input name='input_6' id='input_5_6' type='text' value='' class='medium'      aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_5_3\" class=\"gfield gfield--type-text field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_5_3'>Date of Report<\/label><div class='ginput_container ginput_container_text'><input name='input_3' id='input_5_3' type='text' value='' class='medium'  aria-describedby=\"gfield_description_5_3\"    aria-invalid=\"false\"   \/><\/div><div class='gfield_description' id='gfield_description_5_3'>When was the incident reported to you?<\/div><\/li><li id=\"field_5_4\" class=\"gfield gfield--type-text field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_5_4'>Time of Report<\/label><div class='ginput_container ginput_container_text'><input name='input_4' id='input_5_4' type='text' value='' class='medium'  aria-describedby=\"gfield_description_5_4\"    aria-invalid=\"false\"   \/><\/div><div class='gfield_description' id='gfield_description_5_4'>What time was the incident reported to you?<\/div><\/li><li id=\"field_5_7\" class=\"gfield gfield--type-text field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_5_7'>Date of Incident:<\/label><div class='ginput_container ginput_container_text'><input name='input_7' id='input_5_7' type='text' value='' class='medium'  aria-describedby=\"gfield_description_5_7\"    aria-invalid=\"false\"   \/><\/div><div class='gfield_description' id='gfield_description_5_7'>When did the reported incident take place?<\/div><\/li><li id=\"field_5_8\" class=\"gfield gfield--type-text field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_5_8'>Time of Incident:<\/label><div class='ginput_container ginput_container_text'><input name='input_8' id='input_5_8' type='text' value='' class='medium'  aria-describedby=\"gfield_description_5_8\"    aria-invalid=\"false\"   \/><\/div><div class='gfield_description' id='gfield_description_5_8'>What time approximately did the reported incident take place?<\/div><\/li><li id=\"field_5_9\" class=\"gfield gfield--type-multiselect gfield_contains_required 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_9'>Type of Incident<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_5_9'>Select the type of incident reported (may select more than one)<\/div><div class='ginput_container ginput_container_multiselect'><select multiple='multiple'  size='7' name='input_9[]' id='input_5_9' class='medium gfield_select'   aria-invalid=\"false\" aria-required=\"true\" aria-describedby=\"gfield_description_5_9\"><option value='Homicide' >Homicide<\/option><option value='Sex Offense' selected='selected'>Sex Offense<\/option><option value='Robbery' >Robbery<\/option><option value='Burglary' >Burglary<\/option><option value='Aggravated Assault' >Aggravated Assault<\/option><option value='Motor Vehicle Theft' >Motor Vehicle Theft<\/option><option value='Arson' >Arson<\/option><option value='Weapon(s)' >Weapon(s)<\/option><option value='Alcohol' >Alcohol<\/option><option value='Drugs' >Drugs<\/option><\/select><\/div><\/li><li id=\"field_5_10\" class=\"gfield gfield--type-textarea 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_10'>Location of Crime\/Incident:<\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_10' id='input_5_10' class='textarea medium'   maxlength='100'   aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/li><li id=\"field_5_11\" class=\"gfield gfield--type-radio gfield--type-choice 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' >Was a police report filed?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_5_11'>\n\t\t\t<li class='gchoice gchoice_5_11_0'>\n\t\t\t\t<input name='input_11' type='radio' value='Yes'  id='choice_5_11_0'    \/>\n\t\t\t\t<label for='choice_5_11_0' id='label_5_11_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_5_11_1'>\n\t\t\t\t<input name='input_11' type='radio' value='No'  id='choice_5_11_1'    \/>\n\t\t\t\t<label for='choice_5_11_1' id='label_5_11_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_5_11_2'>\n\t\t\t\t<input name='input_11' type='radio' value='Unsure'  id='choice_5_11_2'    \/>\n\t\t\t\t<label for='choice_5_11_2' id='label_5_11_2' class='gform-field-label gform-field-label--type-inline'>Unsure<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_5_12\" class=\"gfield gfield--type-text 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_12'>Law Enforcement Agency incident was reported to:<\/label><div class='ginput_container ginput_container_text'><input name='input_12' id='input_5_12' type='text' value='' class='medium'      aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_5_15\" class=\"gfield gfield--type-section gsection field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><h2 class=\"gsection_title\">SEX OFFENSES: RAPE, SODOMY, SEXUAL ASSAULT, FONDLING, STATUTORY RAPE<\/h2><div class='gsection_description' id='gfield_description_5_15'>Sex offenses are of special concern to the campus community because they have been historically under-reported. The victim of a sex offense typically desires confidentiality and anonymity, as a result he\/she will often seek a reporting source other than law enforcement such as a designated CSA. Because the sex offender may continue to pose a threat to the community, the threat potential needs to be evaluated and the campus community alerted\/warned as necessary. In this regard, the following additional information is requested. <\/div><\/li><li id=\"field_5_13\" class=\"gfield gfield--type-checkbox gfield--type-choice field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label gfield_label_before_complex' >Was the assailtant:<\/label><div class='ginput_container ginput_container_checkbox'><ul class='gfield_checkbox' id='input_5_13'><li class='gchoice gchoice_5_13_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_13.1' type='checkbox'  value='Unknown offender'  id='choice_5_13_1'   \/>\n\t\t\t\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'>Unknown offender<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_5_13_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_13.2' type='checkbox'  value='Known offender (friend, classmate, acquaintance, date, etc.)'  id='choice_5_13_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_5_13_2' id='label_5_13_2' class='gform-field-label gform-field-label--type-inline'>Known offender (friend, classmate, acquaintance, date, etc.)<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_5_13_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_13.3' type='checkbox'  value='HPU-affiliated'  id='choice_5_13_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_5_13_3' id='label_5_13_3' class='gform-field-label gform-field-label--type-inline'>HPU-affiliated<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_5_13_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_13.4' type='checkbox'  value='Student'  id='choice_5_13_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_5_13_4' id='label_5_13_4' class='gform-field-label gform-field-label--type-inline'>Student<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_5_13_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_13.5' type='checkbox'  value='Staff'  id='choice_5_13_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_5_13_5' id='label_5_13_5' class='gform-field-label gform-field-label--type-inline'>Staff<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_5_13_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_13.6' type='checkbox'  value='Faculty'  id='choice_5_13_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_5_13_6' id='label_5_13_6' class='gform-field-label gform-field-label--type-inline'>Faculty<\/label>\n\t\t\t\t\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_5_26\" class=\"gfield gfield--type-text 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_26'>Name of Assailant (if known):<\/label><div class='ginput_container ginput_container_text'><input name='input_26' id='input_5_26' type='text' value='' class='medium'      aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_5_14\" class=\"gfield gfield--type-text 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_14'>Race\/Gender of Assailant:<\/label><div class='ginput_container ginput_container_text'><input name='input_14' id='input_5_14' type='text' value='' class='medium'      aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_5_16\" class=\"gfield gfield--type-text 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_16'>Age of Assailant:<\/label><div class='ginput_container ginput_container_text'><input name='input_16' id='input_5_16' type='text' value='' class='medium'      aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_5_17\" class=\"gfield gfield--type-text 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'>Height of Assailant:<\/label><div class='ginput_container ginput_container_text'><input name='input_17' id='input_5_17' type='text' value='' class='medium'      aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_5_18\" class=\"gfield gfield--type-text 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_18'>Weight of Assailant:<\/label><div class='ginput_container ginput_container_text'><input name='input_18' id='input_5_18' type='text' value='' class='medium'      aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_5_19\" class=\"gfield gfield--type-text 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_19'>Hair Color of Assailant:<\/label><div class='ginput_container ginput_container_text'><input name='input_19' id='input_5_19' type='text' value='' class='medium'      aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_5_20\" class=\"gfield gfield--type-text 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_20'>Eye Color of Assailant:<\/label><div class='ginput_container ginput_container_text'><input name='input_20' id='input_5_20' type='text' value='' class='medium'      aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_5_21\" class=\"gfield gfield--type-text 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_21'>Physical Characteristics of Assailant:<\/label><div class='ginput_container ginput_container_text'><input name='input_21' id='input_5_21' type='text' value='' class='medium'      aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_5_22\" class=\"gfield gfield--type-section gsection field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><h2 class=\"gsection_title\">HATE CRIMES: hate crime information is required to be reported for each of the following crimes:<\/h2><div class='gsection_description' id='gfield_description_5_22'>High Point University is required to report statistics for hate (bias) related crimes by the type of bias as defined below for the following classifications: murder\/non-negligent manslaughter, negligent manslaughter, sex offenses (forcible and non-forcible), robbery, aggravated assault, burglary, motor vehicle theft, arson, and larceny, vandalism, intimidation and simple assault.<\/div><\/li><li id=\"field_5_23\" class=\"gfield gfield--type-checkbox gfield--type-choice field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label gfield_label_before_complex' >Was the incident motivated by hate or bias?<\/label><div class='ginput_container ginput_container_checkbox'><ul class='gfield_checkbox' id='input_5_23'><li class='gchoice gchoice_5_23_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_23.1' type='checkbox'  value='Unknown'  id='choice_5_23_1'   \/>\n\t\t\t\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'>Unknown<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_5_23_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_23.2' type='checkbox'  value='No'  id='choice_5_23_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_5_23_2' id='label_5_23_2' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_5_23_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_23.3' type='checkbox'  value='Yes'  id='choice_5_23_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_5_23_3' id='label_5_23_3' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t\t\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_5_24\" class=\"gfield gfield--type-checkbox gfield--type-choice field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label gfield_label_before_complex' >If yes, identify the category of prejudice<\/label><div class='ginput_container ginput_container_checkbox'><ul class='gfield_checkbox' id='input_5_24'><li class='gchoice gchoice_5_24_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_24.1' type='checkbox'  value='Race'  id='choice_5_24_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_5_24_1' id='label_5_24_1' class='gform-field-label gform-field-label--type-inline'>Race<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_5_24_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_24.2' type='checkbox'  value='Gender'  id='choice_5_24_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_5_24_2' id='label_5_24_2' class='gform-field-label gform-field-label--type-inline'>Gender<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_5_24_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_24.3' type='checkbox'  value='Religion'  id='choice_5_24_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_5_24_3' id='label_5_24_3' class='gform-field-label gform-field-label--type-inline'>Religion<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_5_24_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_24.4' type='checkbox'  value='Ethnicity'  id='choice_5_24_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_5_24_4' id='label_5_24_4' class='gform-field-label gform-field-label--type-inline'>Ethnicity<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_5_24_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_24.5' type='checkbox'  value='National Origin'  id='choice_5_24_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_5_24_5' id='label_5_24_5' class='gform-field-label gform-field-label--type-inline'>National Origin<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_5_24_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_24.6' type='checkbox'  value='Sexual Orientation'  id='choice_5_24_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_5_24_6' id='label_5_24_6' class='gform-field-label gform-field-label--type-inline'>Sexual Orientation<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_5_24_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_24.7' type='checkbox'  value='Disability'  id='choice_5_24_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_5_24_7' id='label_5_24_7' class='gform-field-label gform-field-label--type-inline'>Disability<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_5_24_8'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_24.8' type='checkbox'  value='Gender Identity'  id='choice_5_24_8'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_5_24_8' id='label_5_24_8' class='gform-field-label gform-field-label--type-inline'>Gender Identity<\/label>\n\t\t\t\t\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_5_25\" class=\"gfield gfield--type-textarea gfield_contains_required field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_5_25'>Description of the incident or crime:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_25' id='input_5_25' class='textarea medium'  aria-describedby=\"gfield_description_5_25\" maxlength='50000'  aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><div class='gfield_description' id='gfield_description_5_25'>Please provide a detailed description of the reported incident or crime. <\/div><\/li><\/ul><\/div>\n        <div class='gform-footer gform_footer top_label'> <input type='submit' id='gform_submit_button_5' class='gform_button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='submit' value='Submit'  \/> \n            <input type='hidden' class='gform_hidden' name='gform_submission_method' data-js='gform_submission_method_5' value='postback' \/>\n            <input type='hidden' class='gform_hidden' name='gform_theme' data-js='gform_theme_5' id='gform_theme_5' value='legacy' \/>\n            <input type='hidden' class='gform_hidden' 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