Person(s) Involved in Incident
Name(s) of Victim(s)
*
Name(s) of Person(s) Accused
*
Witness Information
*
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Incident Information
Date(s) of Incident
*
Student's School(s)
*
Bayard School, The
Brader ES
Brennen School
Brookside ES
Christina Early Education Center (CEEC)
Christina REACH Program
Delaware School for the Deaf
Douglass School
Downes ES
Gallaher ES
Glasgow HS
Christiana HS
Gauger-Cobbs MS
Jones ES
Keene ES
Kirk MS
Leasure ES
Maclary ES
Marshall ES
McVey ES
Middle School Honors Academy at CHS
Networks Program
Newark HS
Oberle ES
Pritchett Academy
Pulaski Early Education Center
Sarah Pyle Academy
Shue-Medill MS
Smith ES
Stubbs Early Education Center
West Park Place ES
Wilson ES
Unknown
What happened?
*
Cyber (online or text)
Excluding (left out)
Inappropriate Comments
Name-Calling
Physical (hit, kicked, punched)
Racial or Demeaning Comments
Rumors
Stolen or Damaged Possessions
Other
Who have you reported the incident to? *
*
Administrator
Counselor
Dean
Friend
Parent/Guardian
Teacher
No one, this is the first report.
Other
Explain the Incident
*
Additional Information
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Person Reporting Incident
Although this information is required, please be assured that it will be kept confidential. If you would like to be contacted for any reason, please provide an email, phone, or address.
Your Name
Email
Phone
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