Bike Theft Report

Demographics and Contact Information
Where did the theft occur?*

Type in name or physical address. If crime occurred off-campus, you must contact the agency responsible for the jurisdiction in which the crime occurred.
I am a*
Name*

First

Middle

Last

Note: if you don’t have a middle name, please enter “none.” Something has to be entered in the field for the form to submit.
Date of Birth*

Month

Day

Year
Race*
Ethnicity*
Gender*
Phone*
CSU ID#
Email
Permanent Address*

Street Address

Address Line 2

City

State / Province / Region

ZIP / Postal Code

Country
Local Address

Street Address

Address Line 2

City

State / Province / Region

ZIP / Postal Code

Country
Driver License #
Driver License State

CSU Police