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.
Sign in to Google to save your progress. Learn more
Name (optional):
Select who you are: *
Nature of Concern (Check all that apply): *
Required
Name of person(s) concerned about: *
Building of Concern (check all that apply): *
Required
Detailed Description of Concern: *
What's the source of the information? *
Required
If you are reporting a concern about a specific student, what is that student's name and grade?
Contact Information (optional):
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Sherburne-Earlville Central School. Report Abuse
Google Forms