ETFO-UCL Safe School Survey

The survey is for ETFO-UCL to monitor the implementation of PPM 144/145 (Ministry of Education's Policy/Program Memorandum - Safe Schools). Please complete this survey each and every time you complete a Safe Schools form. An ETFO-UCL Released Officer may contact you as a follow-up.

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* 1. Last name, First name

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* 2. School

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* 3. Email address

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* 4. SUSPENSION: please indicate the activity (s) committed:
Activities for which suspension must be considered under subsection 306(1) of the Education Act

Uttering a threat to inflict serious bodily harm on another person

Possessing alcohol or illegal drugs

Being under the influence of alcohol

Swearing at a teacher or at another person in a position of authority

Committing an act of vandalism that causes extensive damage to school property at the student’s
school or to property located on the premises of the student’s school

Bullying

Any other activity for which a student may be suspended under board policy - describe

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* 5. EXPULSION: please indicate the activity (s) committed:
Activities for which expulsion must be considered under subsection 310(1) of the Education Act

Possessing a weapon, including possessing a firearm

Using a weapon to cause or to threaten bodily harm to another person

Committing physical assault on another person that causes bodily harm requiring treatment by a
medical practitioner

Committing sexual assault

Trafficking in weapons or in illegal drugs

Committing robbery

Bullying (if the student has been previously suspended for engaging in bullying and the student’s
continuing presence in the school creates an unacceptable risk to the safety of another person)

Any activity listed in subsection 306(1) that is motivated by bias, prejudice, or hate

Giving alcohol to a minor

Any other activity for which a student may be expelled under board policy
[Note: Boards must specify on this form any other activities for which the board may expel according
to board policy.]

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* 6. Please indicate the following which have occurred.

I have completed the PPM 144 form (Safe Schools)

I have submitted the PPM 144 form (Safe Schools) to my administrator

Your administrator has communicated results of this investigation to you at a mutually convenient time.

Your administrator has returned the signed page 2 (acknowledgement of action) to you.

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* 1. Last name, First name

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* 2. School

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* 3. Email address

Question Title

* 4. SUSPENSION: please indicate the activity (s) committed:Activities for which suspension must be considered under subsection 306(1) of the Education Act

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* 5. EXPULSION: please indicate the activity (s) committed:Activities for which expulsion must be considered under subsection 310(1) of the Education Act

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* 6. Please indicate the following which have occurred.

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* 7. Please add comments if you so desire.

* 4. SUSPENSION: please indicate the activity (s) committed:
Activities for which suspension must be considered under subsection 306(1) of the Education Act

* 5. EXPULSION: please indicate the activity (s) committed:
Activities for which expulsion must be considered under subsection 310(1) of the Education Act