Liberty Elementary School Incident Report/ Informe de Incidentes de la Escuela Primaria Liberty

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

Use this form anonymously to report an incident or bullying situation/
Utilice este formulario anónimamente para reportar un incidente o situación de intimidación

Involved Student's Name/Nombre del Estudiante Involucrado *

If name is unknown, please give a brief description of who the person is/Si el nombre es desconocido, por favor dé una breve descripción de quién es la persona

Are there any other people to report?/¿Hay alguna otra persona que reportar? *

Yes/Si

Names of others involved/Nombres de otros involucrados

Victim's Name/Nombre de la víctima *

What is your relationship with the victim?/¿Cuál es su relación con la víctima? *

Parent/Padre

Friend/Amigo(a)

Victim/Víctima

None/Ninguna

Other:

Please describe the incident and where it happened/Describa el incidente y dónde ocurrió *

Witness Name(s)/Nombre (s) de testigo(s)

If you would like to provide your name, please feel free to do so, but it is not required/Si desea dar su nombre, no dude en hacerlo, pero no es necesario

Submit

Clear form

Never submit passwords through Google Forms.

This form was created inside of Santa Maria-Bonita School District.

Does this form look suspicious? Report

Forms