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First Name

Last Name

Email Address

Telephone Number

Address

City/Town

State/Province

ZIP/Postal Code

Country

Please provide the address where the incident occurred, including building name (if applicable).

Date and Time of Incident

Approximate date and time in which the incident occurred.

Incident Details

Please provide details surrounding the incident that you are reporting.

*Note: If this is an emergency or an urgent matter that requires immediate attention, please call 911 or the Campus Safety Emergency Line at 905-569-4333.

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