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Safety and Security Forms
The forms included below should be completed and then turned in to the Safety and Security Department. In
those cases where the faculty, staff, or student is on one of GBC's campuses they should
contact the Campus Director or in Elko Security so information may be obtained directly and,
if required, photos taken. If an incident occurs while traveling the state, please let your
Supervisor know at your earliest convenience from a safe location.
The following forms are available from this site:
- Claim Against the State of Nevada (PDF*),
for use by a person filing a claim against one of our campuses or vehicles. The person filing
the claim must complete and submit the form.
- Security Incident Report Witness Statement (PDF*),
for use by any witness or person filing an incident report with Security or a Campus Director.
This statement should be turned in to the Safety & Security
Director.
- Property Loss Report (PDF*), use
for reporting thefts or damageto NSHE Property that exceeds $2,000 (excluding Motor Vehicles)
and for reporting boiler and machinery losses that exceed $2,000.
- Windshield/Glass Loss Report (PDF*),
for use by an NSHE employee driving an agency vehicle when a window is broken. This report should
be turned into the Safety & Security Director along with a witness statement explaining
the circumstances of the damage.
*Viewing a PDF document requires the Adobe Reader plugin for your browser, available free from
Adobe.
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