Incident Report
Suspected Abuse
Name of Student Involved:
Birthdate: Male Female
Parent or Guardian: Phone:
Address:
Name of Alleged Abuser:
Date and Place of Incident or Incidents:
Description of Misconduct (Attach report if necessary):
Name of Witnesses (Complete witness report):
1)
2)
Other Information (Inc. evidence of abuse, i.e. letters, photos, etc.):
I agree that all of the information on this form is accurate and true to the best of my knowledge.
Signature of Investigator Date
Witness Disclosure Form
Name of Witness:
Position of Witness:
Date of Testimony, Interview:
Description of Instance Witnessed (Attach report if necessary):
Other Information:
I agree that all of the information on this form is accurate and true to the best of my knowledge.
Signature of Witness Date