You may print this form and drop it in the anonymous box in the guidance office at the school, or email it directly to the Principal or Vice-Principal.

Date: ____________________ Victim's Name: ______________________________

Students who saw what happened: ________________________________________

_________________________________________________________________

_________________________________________________________________

What Happened? _____________________________________________________

_________________________________________________________________

_________________________________________________________________

_________________________________________________________________

Where/ When? ______________________________________________________

Your name (if you wish): _______________________________________________

If you are a staff member, click here for the relevant staff reporting form.

Page last updated: September 25, 2006 2:24 PM by S. Robertson-Little