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KISD Safety/Security Issue Reporting Form
1. Notify admin/office of issue to ensure safety first.
2. Complete/submit this form for documentation.
* Indicates required question
Email
*
Record my email address with my response
Requestor Name:
*
Your answer
Nature of Issue:
*
Choose
Problem with Gate(s)
Problem with Door(s)
Problem with Building Access
Facilities: Identified Safety Hazard
Other
Location of Issue:
*
Choose
Main Building
Bielfeldt Elementary Building/Cafeteria/Library
Schneider Early Learning Building/Schneider Center
Vulcan Gym
Portables
Playground
Outdoor Sports Complex Area
Other Outdoor Area
Other (not listed)
Location Description (Please include additional details as needed):
*
Your answer
Description of Issue: (Please include additional details as needed):
*
Your answer
Remainder of Form for Office Use Only.
Please scroll down and submit.
Your answer
Responding Staff Member:
Your answer
Completion Date:
Your answer
Description of Work Completed
Your answer
Issue Resolved?
Choose
Yes
Additional Work Needed (describe in next section)
Additional Info:
Your answer
Secondary Completion Date:
Your answer
Description of Secondary Work Completed:
Your answer
Send me a copy of my responses.
Submit
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