Please use this form to report any student about whom you are concerned and why. You may be contacted for clarifying information by a member of the Behavioral Intervention Team. Please understand that any follow up with the student of concern is confidential. IF THIS IS AN EMERGENCY, CALL 911 AND CONTACT SMCC SECURITY AT 207-741-5553 IMMEDIATELY.

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* Student First Name

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* Student Last Name

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* Student ID Number

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* Reporting Person Name

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* Reporting Person Contact Information

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* Please describe the nature of your concern in as much detail as possible.

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