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By completing this form, you as the Clery Liaison or Dean, Director, Department Head are identifying those within your Department who qualify as UIS Security Authorities.
Please refer to the UIS Police Campus Security Authorities page for assistance in identifying who your Department's CSAs may be.
Any questions about this form should be referred to the Compliance Coordinator at the UIS Police Department.
Please provide all information requested for a single CSA. You must complete each field.
CSA Information
If you have additional CSAs to register, please submit this form and complete a new CSA form for each additional employee.