AMOT Safe Schools Survey

The survey is for the AMOT Local to monitor the implementation of PPM 144/45 (Ministry of Education's Policy/Program Memorandum - Safe Schools). Please complete this survey each and every time you complete a Safe Schools Incident Report (SSIR). An AMOT Released Officer may contact you as a follow up.

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* 1. Date of Incident

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* 2. Last name, First name:

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* 3. School:

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* 4. Email address:

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* 5. Phone # where you can be reached most easily (please note if home/office/cell)

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* 6. 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

Injurious to the physical or mental well-being of members of the school community

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

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* 7. Please add comments if you so desire:

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* 8. Were you injured, or did you have the potential of being injured during the incident that prompted the completion of the Safe Schools report?

Yes

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* 9. Do you feel unsafe in this particular classroom or school?

Yes

Comment

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* 10. If you answered Yes to question 8, have you completed an Employee Accident and Incident Report electronically via the Core?

Yes