Request edit access
JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Anonymous Reporting
This form is designed to allow staff or students to contact WCA admin anonymously in the case of any inappropriate or worrisome student or staff behavior. The form will go directly to the WCA Dean of Students' email to alert them of any potential behavior patterns to be aware of. No name is required.
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Academy
*
Kite
Climb
Kayak
MTB
You are currently a WCA
*
Staff
Student
Gardian
Contacting regarding
*
Student Behavior/Conduct
Staff Behavior/Conduct
Required
Honor Contract Violation
*
Drug Use
Alcohol Use
Tobacco use
Bullying/Harrasment
Sexual Misconduct, including Assault, Harassment, or Violence
Academic Dishonesty/Cheating
N/A
Other:
Required
Concerns over staff professionalism or conduct
*
Safety or competency on water/rock/bike
Staff behavior or competency off water/rock/bike
N/A
Other:
Required
Staff Conduct
*
Inappropriate substance use, including drugs or alcohol
Inappropriate language; including profanity, bullying, or harassment in the classroom
Inappropriate language; including profanity, bullying, or harassment outside the classroom
Inappropriate or unsafe behavior while driving a WCA vehicle
Inappropriate relations with a student
Inappropriate or unprofessional conduct outside of WCA enviroment
N/A
Other:
Required
Frequency of behavior?
One time incident
Recurring incident
Daily
Clear selection
When did the behavior start?
Your answer
Has the behavior improved, remained the same, or increased?
Improved
Remained the same
Increased/Worsened
Clear selection
Any additional information you would like to share concerning the above responses? For example the name of the person(s) involved or an account of the problematic behavior, including time, date, or location.
Your answer
What, if any, is the desired follow-up?
Your answer
Any questions? (For more information regarding harassment and appropriate behavior while in a WCA environment, please refer to the staff and student handbooks. )
Your answer
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of World Class Academy.
Does this form look suspicious?
Report
Forms
Help and feedback
Help Forms improve
Report