School Concern Form
If you feel there is an immediate threat (yourself or others), please call the proper authorities.
Student well-being and safety are of our utmost concern and something SECSD takes very serious. Please fill out this form to alert and disclose concerns to the SECSD. Information will be used to ensure the safety and well being of everyone in the district. As always, you can always call the district at (607) 674-7300 to talk to someone directly.
Thank You.
* Required
Name (optional):
Your answer
Select who you are:
*
Student
Parent
Community Member
Nature of Concern (Check all that apply):
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Bullying
Peer Conflict
Alcohol/Tobacco/Drugs Use
Other:
Required
Name of person(s) concerned about:
*
Your answer
Building of Concern (check all that apply):
*
Elementary School
Middle School
High School
Required
Detailed Description of Concern:
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Your answer
What's the source of the information?
*
Social Media
Conversation (first hand)
Other:
Required
If you are reporting a concern about a specific student, what is that student's name and grade?
Your answer
Contact Information (optional):
Your answer
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