Campus Security Authority Crime Report Form

Henderson State University encourages students, employees and guests to report any suspected criminal activity, emergencies or public safety-related incidents on campus promptly as follows:

In an emergency, call 911

In situations in which you hear shots fired on campus or if you witness and armed person shooting or threatening people, follow the university's Active Shooter/Violent Behavior protocol. This protocol includes the instructions to call 911 when it is safe to do so.

In non-emergency situations at the Henderson State Police Department at 870-230-5098 (or 5098 from on-campus telephones).

Some situations require special reporting pursuant to state law and university policy.

  • In the event of a situation involving sexual assault, rape, sexual harassment or other misconduct that violates the university's Policy Prohibiting Sex-and Gender-Based Discrimination, Harassment, Misconduct and Retaliation (also referred to as the "Title IX Policy"), university employees are required to contact the Title IX Coordinator at 870-210-9651 or by email to in order to discharge their duties as "Responsible Employees." Please note that individuals who report experiencing this type of conduct have the right to choose not to contact law enforcement.
  • In the event of a situation involving suspected abuse or neglect of a person under the age of 18, university employees are required to report what they know to the Arkansas Child Abuse Hotline at 1-800-482-5964. In an emergency situation, employees should first call 911. In all other situations, the first call they should make after becoming aware of a situation of child abuse or neglect is to the Arkansas Child Abuse Hotline.

This form is for the university’s Campus Security Authorities (CSAs) to report information.

Pursuant to the Clery Act, Henderson State University is required to compile and publish crime statistics in an Annual Security Report. As part of this obligation, CSAs are required to report crimes for inclusion as statistics in the Annual Security Report.

When you submit this form, it will be electronically transmitted to the Henderson State Chief of Police, the Clery Compliance Coordinator and the Title IX Coordinator. The university will review the information provided and make a determination if an incident warrants an Emergency Notification, Timely Warning Notice or a Community Advisory to the Henderson State community and whether it is a reportable crime. Notifications will not contain identify the victim.

Henderson Police Human Relations Office Title IX Office Judicial Affairs Office Other
Homicide - Murder Negligent Manslaughter Aggravated Assault Rape, Sodomy, Sexual Assault with Object Fondling Statutory Rape Incest Burglary - structure - not for vehicles Robbery Motor Vehicle Theft Arson Dating Violence Domestic Violence Stalking Other
Arrest Disciplinary Referral Other
Arrest Disciplinary Referral Other
Arrest Disciplinary Referral Other
Yes, please continue No, go to the Submit button at the bottom of the form
Simple Assault Larceny Intimidation Vandalism any other crime involving bodily injury
Race Ethnicity Gender Religion Disability Gender Identity National Origin Sexual Orientation Not applicable