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CCTV REQUEST TO VIEW FORM 2026
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Step
1
of 4
Date of Report
Reported by:
Staff
Students
Outsiders
Phone Number
*
Email
*
by: Method: INFORMATION:
INCIDENT INFORMATION:
Date / Time
Date
Time
LOCATION:
(Incident Description)
APPEARANCE
(identifying clothing, posture, or identity)
INCIDENT TYPE:
Lost / Misplaced
Theft / Stolen
Fighting
Bullying
Smoking
Drinking / Alcohol related
Sexual Harassment
Vandalism
Other:
INCIDENT DESCRIPTION:
WITNESSES:
(Name / Role / Contact)
Next
REPORTING OF INCIDENT:
INCIDENT REPORTED TO:
Security
HR
ICT
Student Administration
(Tick Option)
Other:
(Please specify)
Reporting Method:
This form
In Person
Email
Phone
Other:
(Please specify)
Next
DONT FILL THIS PART OF THE FORM. ICT USE ONLY
CCTV Admin:
Was the reported incident solved by CCTV?
Yes (Provide details on how the incident was solved).
No (Provide details how CCTV was not able to solve this incident).
Cancel
Details:
(Provide the actual time the event occurred).
FOLLOW UP ACTION:
(Description of actions to be taken)
Release of CCTV Footage
Approved
Not Approved
(CCTV Policy 6.5)
Next
AUTHORISATION:
SUPERVISOR’S NAME:
Date
Submit
