CSA Travel Registry

Locations where students travel for one or more nights for university-sponsored business or activities may be subject to Clery reporting requirements. If you are traveling with students and you or UW-Madison has written agreement to control space that the students will be using, please provide the information requested below.  A written agreement can be anything from a formal contract, to a hotel reservation, to an email.  For questions regarding this form, please contact Jaimee Gilford, Clery Program Director.


YOUR NAME:

POSITION/DEPARTMENT/STUDENT ORGANIZATION:

YOUR EMAIL ADDRESS:

YOUR PHONE NUMBER:

TYPE OF LOCATION (HOTEL ROOMS, CLASSROOMS, CONFERENCE ROOMS, ETC.):

ADDRESS OF LOCATION(S):

DO YOU HAVE A WRITTEN AGREEMENT TO CONTROL THIS SPACE(S)? PLEASE EXPLAIN FOR EACH ADDRESS LISTED:

DATES WHEN STUDENTS WILL BE USING THE SPACE:

TO YOUR KNOWLEDGE, HAS UW-MADISON HAD A WRITTEN AGREEMENT TO USE THIS SPACE IN THE PAST 12 MONTHS?

IS A CAMPUS SECURITY AUTHORITY TRAVELING ON THIS TRIP? IF SO, PLEASE LIST THEIR NAME(S) AND EMAIL ADDRESS(ES)?

IF YOU HAVE TRAVEL RELATED FILES, YOU CAN ATTACH THEM HERE:

Please note: if you are an employee of UW-Madison and you are travelling with students, you are a Campus Security Authority.  Please make sure you have completed CSA training so you are aware of your crime reporting responsibilities.


Why do I have to provide this information?

  • The federal Clery Act requires that institutions track what is known as “non-campus” property, and report certain crimes that occur at those locations. Non-campus property includes property that UW-Madison controls on a short-term basis if there is a written agreement for the property, the property is frequented by students, and it is used to further UW-Madison’s educational mission. UW-Madison is required reach out to the local law enforcement agencies with jurisdiction over non-campus property and request crime statistics for the dates and times when UW-Madison controls the space.  UW-Madison must provide the statistics, if any, to the federal government and publish them in the Annual Security and Fire Safety Report.
  • Campus Security Authorities are required to forward crime reports they receive either using the online CSA reporting form or if there is no internet access where the CSA receives the report, by calling UWPD dispatch at (608) 264-2677