CLERY TRAVEL FORM


There are a number of reporting elements required for compliance with the Clery Act. This page is focused on helping you to report Clery‐mandated travel information. There are specific variables that we will work to verify to determine if your trip is reportable. Once we do that, we will ask you follow‐ up questions, as necessary, to complete the reporting. Before we get started, it is helpful for you to have the trip documents at hand, including the address and arrival/departure dates at any accommodations at which you stayed.

For incident queries/questions or to make a report: secure-clerycsa@lists.stanford.edu
For general CLERY information, contact: vbergado@stanford.edu Phone: (650)‐736‐7423


Step 1

Yes

No

Step 2

Yes

No

Step 3

Contact Information


Travel Description



Add more Remove

Step 4

No

Yes