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Gustine ISD Safety/Threat Reporting Form
This form is to be used to report safety/threat issues. The purpose of this form is to alert Gustine ISD Administrators of possible safety/threat issues so they can conduct a thorough investigation. Providing more detailed information will lead to a more thorough the investigation.
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* Indicates required question
Date
*
MM
/
DD
/
YYYY
Person making report: (This is optional, however by giving us your name it will make a thorough investigation easier.)
Your answer
I am a:
*
Current Gustine ISD Student
Parent/Guardian of a Current Gustine ISD Student
Member of the Gustine ISD Staff
Other:
Day Time Phone Number (optional)
Your answer
Address (optional)
Your answer
Email Address (optional)
Your answer
Person or Persons That Are Threatening the Safety of a GISD Campus or Employee or Student (if known)
Your answer
Person or Persons or Campus That Are The Target of a Safety Threat (Please provide first and last names.)
*
Your answer
Date of Incident
*
MM
/
DD
/
YYYY
Time of Incident
*
Time
:
AM
PM
Type of Threat
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Verbal
Written
Physical
Electronic
Option 5
Other:
Witnesses (List people who saw or heard the threat or that have relevant information about the threat. Please tell us if the witness is a parent, staff member, student or community member.)
*
Your answer
Describe the incident in detail, including the name of the person or persons involved, what was said and done, and specific words used.
*
Your answer
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