Glen Rock High School Incident Reporting Form
Please note that this form and it's submissions are ONLY monitored during school days and hours. If you are reporting something that is a true emergency or you believe may be life-threatening, call 911 or the Glen Rock Police Department (201) 652-3800.

The field for your name/contact info/role are optional, although we prefer to be able to contact you if more information is needed.

Please only complete the relevant section below.

Your Name (Optional)
Your answer
Email Address (Optional)
Your answer
Phone Number (Optional)
Your answer
Your role in the community (Optional)
What are you reporting?
Attachments Upload
Use this link to anonymously upload screenshots, videos, etc, that relate to this incident: https://sendtomycloud.com/GRHS
Harassment, Intimidation and Bullying (HIB)
Skip this section if it does not apply to your report.
If harassment, intimidation and bullying, please indicate names of victim(s).
Your answer
If harassment, intimidation and bullying, please indicate names of witness(es) if any are known.
Your answer
If harassment, intimidation and bullying, please indicate names of aggressor(s).
Your answer
What did you observe that you would like to report? When did this occur? Is it still occurring?
Your answer
Where did this occur? Please be specific.
Your answer
Self-Harm
Skip this section if it does not apply to your report.
Name(s) of student(s) you believe may be in danger.
Your answer
Why do you believe this student may be self-harming or suicidal? Please give as much detail as possible.
Your answer
Unsafe Conditions
Skip this section if it does not apply to your report.
Describe the safety hazard or unsafe conditions at the school. Please give as much detail as possible.
Your answer
Other
Skip this section if it does not apply to your report.
What did you observe that you would like to report? When did this occur? Is it still occurring? Where?
Your answer
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