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.

Name of person completing this form: (optional)

Grade: (optional)

List the name of student(s) accused of bullying, sexual harassment, or dating violence: *

Relationship between you and the accused student: *

List all times/places you encounter the accused person on a daily basis: *

When did it happen? *

YYYY

Where did it happen? *

Describe the incident: *

Were there any witnesses? *

Yes

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