If this is an emergency situation, contact the Florida State University Police Department at (850) 774-2705. This form should not be the primary means of reporting an emergency situation in progress. All FSU Panama City and Gulf Coast State College community members have complete access to the Seminole Landing Report. Your Contact Information (Not Required) Full Name What is your relationship to Seminole Landing? Phone FSU Email Address To remain anonymous, do not change the pc-seminolelandingreport@lists.fsu.edu email address. Only provide your email address if you wish to be contacted. Additional Information To remain anonymous, do not change the pc-seminolelandingreport@lists.fsu.edu email address. Only provide your email address if you wish to be contacted. Your Concern Nature of This Report - None -Maintenance/FacilityMarchman Act (alcohol/drug transport)Medical Transport (health/injury)Peer ConflictStudent Conduct (Policy Violations)Student Issue GCSCStudent Issue FSU PC Location_2 Location_2 - Select -Unit AUnite A1Unit A2Unit BUnite B1Unit B2Unit CUnit DCommunity RoomGymPoolStudy RoomParking LotOther… Enter other… Further comments on location Floor Floor - Select -First FloorSecond FloorThird FloorFourth FloorOther… Enter other… Description of concern or issue Date & Time of Incident Date & Time of Incident: Date Date & Time of Incident: Time Involved Parties Please list the individuals involved, including witnesses, and for each of them, please include as many of the listed fields as you can provide. Do NOT list yourself or other staff, or police/emergency officials in this section (but they should be identified in the narrative below). Name Gender SelectMaleFemale Select Role Select Role - None -RespondentBuilding/FacilityStudent of ConcernComplaintantWitnessOther… Enter other… Student ID Additional Person Involved (Click to expand) Name Gender SelectMaleFemale Select Role Select Role - None -RespondentBuilding/FacilityStudent of ConcernComplaintantWitnessOther… Enter other… Student ID Additional Person Involved (Click to expand) Name Gender SelectMaleFemale Select Role Select Role - None -RespondentBuilding/FacilityStudent of ConcernComplaintantWitnessOther… Enter other… Student ID Supporting documents may be attached below. 2MB maximum total size. Attachments require time to upload, so please be patient after submitting this form. Document Files Upload Upload requirementsUnlimited number of files can be uploaded to this field.20 MB limit.Allowed types: txt, rtf, pdf, doc, docx, odt, ppt, pptx, odp, xls, xlsx, ods. Image Upload Upload requirementsOne file only.20 MB limit.Allowed types: gif, jpg, png. Additional Information CAPTCHA Get new captcha! What code is in the image? Enter the characters shown in the image. This question is for testing whether or not you are a human visitor and to prevent automated spam submissions. Submit
