Port Washington High School                 Request for Investigation:
If you would like an administrator to investigate and incident that happened to your child at school, please fill out the form below.
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Email *
Date
MM
/
DD
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YYYY
Student Name
Grade
Teacher
Time of Incident
Time
:
Name of person completing report
Location of Incident
Incident Summary
Please list previous incidents related to this complaint (with dates if possible):
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