Childress ISD Complaint Form
By submitting this Complaint Form, you certify that all statements made in the complaint are true and complete. Any intentional misstatement of fact will subject you to appropriate disciplinary action. I authorize school officials to disclose the information I provide only as necessary in pursuing the investigation.
* Required
Childress ISD Complaint Form
Name of person completing this form: (optional)
Your answer
Grade: (optional)
Choose
PK
K
1st
2nd
3rd
4th
5th
6th
7th
8th
9th
10th
11th
12th
List the name of student(s) accused of bullying, sexual harassment, or dating violence:
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Your answer
Relationship between you and the accused student:
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Your answer
List all times/places you encounter the accused person on a daily basis:
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Your answer
When did it happen?
*
MM
/
DD
/
YYYY
Where did it happen?
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Your answer
Describe the incident:
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Your answer
Were there any witnesses?
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Yes
No
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