Safety Concerns Listen This Safety Concern Form will be evaluated by a Safety Services representative and an investigation will be conducted. Location of safety concern: (Building & Room Number)(Required) Is there an immediate life threatening danger to the NCC Community?(Required) Yes No Description of safety concern (unsafe act or conditions):(Required)Select all those affected by the unsafe situation:(Required) Students Employees Contractor's Employees Visitors Other "Other" who may also be affected by unsafe situation:(Required) Please select your current status:(Required) Staff Faculty Student Other "Other" Current Status:(Required) Name(Required) First Last Email(Required) Phone(Required)Signature(Required) Reset signature Signature locked. Reset to sign again CAPTCHA
