Anonymous Reporting Tool
Regional School District 17 is providing this option to anonymously report safety concerns to help prevent violence and tragedies. This reporting system is not monitored 24 hours per day. Call 911 immediately if you believe you are experiencing an emergency. You may provide your contact information below, which will be helpful if we need more information.
School *
Event Description *
(Including... Who, What, When, Where and How Do You Know)
Concern/Event Type * *
When did or when will the event occur?
MM
/
DD
/
YYYY
Who is/are the person(s) you are concerned about?
Please provide as much information as you have. Persons' name, location, approximate age.
Optional Information about reporter
NOTE: If you provide your name and/or contact information, you acknowledge that it may be provided to assist in resolving the concern or threat you are reporting. If you deliberately provide false information or use this system to threaten or harass someone, you may be subject to criminal prosecution.
Sandy Hook Promise Acknowledgement
This form's options and format are based on the "Say Something" reporting system created by the Sandy Hook Promise foundation. However, this form is solely the responsibility of the Region School District 17 Higganum, Connecticut.
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Regional School Distrct 17.

Does this form look suspicious? Report