Home > Student Life > Safety & Security > Contact Us > Complaint Form

Public Safety Complaint Form

Either fill out this form and submit it online or print out a PDF of the form and mail it to: Director of Public Safety, 1616 9th Ave South, Moorhead, MN 56563.

* indicates a required field

Please provide information about the Public Safety employee(s) involved.

Employee Involved Name:*

Employee Badge Number:

Employee Involved Name:

Employee Badge Number:

Please provide information about the incident.

Location:*

Date & Time of Occurrence:*

Complainant Information

Name:*

Address:

Phone:

Witness Information

Name:

Address:

Phone:

Details of Complaint:*

Emergency Information
Forms
Key & Card Access
Maps & Parking
Safety & Crime Prevention
Security & Fire Safety Report
Services
Contact Us

Request Info
Visit Campus
Apply Now