L.C. Bird High School's See Something Say Something Form

If this is an emergency that requires immediate attention, call 911. Please use this form to report incidents of bullying, harassment, fighting, theft, vandalism, or anything you feel should be reported to L. C. Bird's High School's Administration Team. This account will be monitored ONLY during regular school hours on days when school is in session for students. While the average response time should be within one school day, please be aware that it may take two school days for a school official to contact you.
Your Name
You may choose not to give your name. However, we must have your name if you wish for us to contact you regarding this report.
Your answer
Date incident happened * *
MM
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DD
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YYYY
Time incident happened * *
Hrs
:
Min
:
Sec
Names of students and/or adults involved. * *
Please list the name(s) of students and/or adults involved. Please list one name per line.
Your answer
Where did the incident take place (example: cafeteria, upstairs hallway, locker room, etc.) * *
Your answer
Please describe what happened. * *
Your answer
Were there any witnesses? *
Please list the name(s) of any witnesses. Please list one name per line.
Your answer
Is this the first time this has happened? *
If no, how many other times has this happened before? *
Your answer
Other information about previous incidents or threats. *
Please add any additional information about previous incidents or threats, or any relevant information you think we need to know.
Your answer
By submitting this form I agree that all of the information on the form is accurate and true to the best of my knowledge. By submitting this form electronically, I understand that it will be sent or forwarded to the correct administrator. If you would prefer to give this form directly to a building administrator, please make a copy and deliver it. Thank you for your response!
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