Safe And Caring Schools Incident Reporting Form printable pdf download

Safe and Caring Schools Incident Reporting Form – Part I

REPORT

School Name

NO:

Name of Students

Involved (if known)

At a location in the school or on school property

At a school related activity ( specify)

Location of

(specify)

Other (specify)

Incident

On a School Bus (specify route number)

Date and Time

Incident Date:

Time:

Type of Incident (please check all that apply)

Suspension a Principal shall consider (Education Act, Part XIII, Section 306(1))

1. Uttering a threat to inflict serious bodily harm

4. Swearing at a teacher or at another person in a

on another person

position of authority

2. Possessing alcohol or illegal drugs

5. Committing an act of vandalism that causes

extensive damage to school property at the pupil's

school or to property located on the premises of the

3. Being under the influence of alcohol

pupil's school

6. Bullying

Suspensions that may be considered (Education Act, Part XIII, Section 306(1)(7))

1. Wilful destruction of school property;

vandalism causing damage to school or Board

10. Fighting

property or property located on school or Board

premises

2. Use of profane and improper language

11. Possession or misuse of any harmful substances

3. Use of tobacco

12. Hate motivated violence

4. Theft

13. Extortion

5. Aid/Incite harmful behaviour

14. Distribution of hate material

6. Physical Assault

15. Inappropriate use of electronic communication/media

7. Being under the influence of illegal drugs

16. An act considered by the Principal to be a breach of the

Board's or school's Code of Conduct:

8. Sexual harassment

Please specify the breach (30 characters max.)

9. Racial harassment

Suspension pending possible expulsions (Education Act, Part XIII, Section 310(1))

1. Possessing a weapon, including a firearm

5. Trafficking in weapons or in illegal drugs

2. Using a weapon to cause or to threaten

6. Committing robbery

bodily harm to another person

3. Committing physical assault on another

person that causes bodily harm requiring

7. Giving alcohol to a minor

treatment by a medical practitioner

4. Committing sexual assault

Suspension pending possible expulsions (Education Act, Part XIII, Section 310(1)(8))

2. An act considered by the Principal to be a Serious Breach

1. Possession of explosive substance

of the board's or school's code of conduct: please specify the

breach (30 characters max.)

Report Submitted By:

Name:

Signature:

Date:

Contact Information Location :

Telephone:

Safe And Caring Schools Incident Reporting Form

Related Articles

Related forms

Related Categories