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Student Incident Reports
This form is used for any incidents that happen on campus, as well as off campus (school related events). Be sure to fill this out in great detail
Date of the Incident
MM
/
DD
/
YYYY
Your Last Name
Your answer
Your First Name
Your answer
Time of the Incident
Time
:
Name of the Offenders (if you do not know names then give details as to how I can find out who they are)
Your answer
Was there a victim?
Name the victim(s) involved. Put N/A or None if there isn't one.
Your answer
Where did the incident happen? (outside, inside, hallway, where specifically?)
Your answer
Describe the incident as clearly as possible. Give full details of the event.
Your answer
Have you reported this before? (Teacher, someone on staff)
Who did you report it to and when?
Your answer
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