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REPORTING PERSON'S INFORMATION
IF THIS IS AN EMERGENCY REQUIRING IMMEDIATE ASSISTANCE, PLEASE CALL 911.
***If you wish to remain anonymous, do not fill in your name/phone/email. However, anyone who makes a report is protected against retaliation.
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* Indicates required question
Name of Reporting Person:
Your answer
Your telephone number (xxx-xxx-xxxx):
Your answer
Your email address:
Your answer
Your relation to the school district:
*
Student
Parent/Guardian
Employee
Bystander
Other:
Name of school adult you have already contacted (if any):
Your answer
Does the victim know you are submitting this report?
*
Yes
No
Does the offender know you are submitting this report?
*
Yes
No
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