Please provide the name(s) of all persons (including yourself, if applicable) who are part of your concern/report, along with their grade level in school if known *
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Please describe your concern. *
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When and where did this take place? Please indicate date, time and location. *
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Were you a witness to your concern? (Did you see it happen?) *
Please provide the names of any other individuals we should speak with regarding this report.
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By selecting "yes," I hereby confirm that I am truthfully reporting this incident and that my report contains no false allegations. *
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