**Important: Reports will be checked on days when school is in session. If you have a concern that requires immediate attention, please notify a trusted adult or the authorities. Thanks!!

* 1. What would you like to report? What did you see or hear?

* 2. When did this happen? Date and Time.

* 3. Your name (optional)?

* 4. Who was involved? (First and last names if you know it.)

* 5. Other witnesses?

* 6. Would you like to meet with a counselor about this? If so, please answer question #3 with your first and last name.