EYSD Bus Driver Incident Report Form
The purpose of this report is to inform you of a disciplinary incident on the school bus involving the student listed, which may have jeopardized the safety & well-being of all students. You are urged to both respect the action taken by the driver and cooperate with the corrective action initiated today by the school district. 
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Email *
Student Last Name *
Student First Name *
School Name *
Student Grade
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Date of Incident *
MM
/
DD
/
YYYY
AM or PM Run *
Approximate Time of Incident if known
Type of Infraction *
Required
Description of Infraction *
Please list names of any other students involved or part of the incident.
Action taken by driver *
If assigned seat was moved, please list the seat you moved them to and the approximate date you moved them to the new seat.
Do you feel the incident requires the bus tape to be reviewed?
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