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Warning: This form is used to anonymously report incidents. It is only monitored during school hours and school events. If this is an emergency call 911 immediately. Please note the importance of this reporting form and be aware that law enforcement may be involved in the monitoring of this tip.
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I am a SJSC student
What is the incident type?
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Bullying report
Concern for self of others
Harassment
Physical Abuse
Threat to school or students
Date of incident
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MM
/
DD
/
YYYY
Time of incident
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Time
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AM
PM
What is the description of the tip?
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Your answer
Name of student/victim/facility
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Your answer
What is the location of the incident? (which classroom, playground, bathroom, hallway, field)
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Your answer
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