Accident and Incident Report

Incident/Accident Report for Kalamazoo College Vehicle Users

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What kind of Incident has occured?(Required)

Your Name:(Required)

First Last

Your Email:(Required)

Your Phone Number:(Required)

Your Address:(Required)

Street Address City State ZIP Code

Details of the Incident

Please provide us with as much detail as possible.

Date of Incident:(Required)

Time of Incident:(Required)

Location of Incident:(Required)

Street Address Include any nearby intersections or other helpful descriptors. City State / Province / Region

Did you have any passengers?(Required)

Passenger(s) Full Name and Contact Information:(Required)

Please include their full name(s) and contact information.

Were the Police Contacted?(Required)

Please provide Police Report number:(Required)

A Police Report is required for any accidents while using a Kalamazoo College Vehicle. All emergencies should be reported to Facilities Management as soon as possible or Campus Safety after hours.

Description of Incident:(Required)

Please describe what happened. Make sure you are clear and objective: Include details about what happened before the incident, the incident itself, and actions that were taken immediately after. Please provide a brief summary of the damages and any relevant property damage.

Please provide images of the Incident:

Drop files here or

Max. file size: 5 MB.

Other Parties Involved

Please collect names and contact information of all involved parties and/or witnesses.

Where there other Parties Involved?(Required)

Their Name:(Required)

First Last

Their Phone Number:(Required)

Additional Information:(Required)

If more people were involved, please include their full name(s) and contact information.