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Bullying/Harassment Incident Reporting Form
At the York School Department safety and respect are important behaviors in our schools. We expect it of all students and adults. Please use this form to share your concern. This report will be reviewed by school administration within 24 hours.
Date of Incident *
mm/dd/yyyy
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Approximate Time of Incident: *
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Location of Incident
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If other, please explain:
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Names of people involved: *
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Please report the details of the incident: *
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Contact Information
Address/Phone Number/etc.
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