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Incident Reporting Form
San Diego ISD
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Email *
Today's Date *
MM
/
DD
/
YYYY
First Name (Confidential) *
Last Name (Confidential) *
Relationship to alleged victim/offender (optional)
Identify alleged bully *
Required
Name of Bully(s) *
List alleged victim or victim's names *
List names of witness(s) to the incident *
Incident Date *
MM
/
DD
/
YYYY
Incident Time *
Time
:
Did the alleged incident occur on school property? *
Did the alleged incident occur at a school sponsored activity? *
Campus *
Location of the incident examples cafeteria, gym, football field etc. *
Types of Harassments *
Required
Incident Description (all written statements must be submitted with date and signatures) *
Has anyone in the school helped you with this complaint? *
Have you previously reported this incident? *
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