SAFETY AND SECURITY - SAMPLE FORM - REPORT TO LAW ENFORCEMENT (LINK TO EBC & JDDB)
SAFETY AND SECURITY REPORT TO LAW ENFORCEMENT
EBC/JDDB SAFETY AND SECURITY REPORT TO LAW ENFORCEMENT
– Sample Form –
Retype to suit local needs, remove from policy book and file with the clerk and principals. Form could also be included in staff or student handbooks.
Safety and Security Report to Law Enforcement Form - Printable Version
Report to Local Law Enforcement USD 443
Pursuant to K.S.A. 72-6143, the administrator or other school employee whose signature appears below is reporting the following crimes. {Briefly describe each incident and the person/s involved in felonies, misdemeanors and weapons}
| Date | School/ Location | Student/s or Person/s Involved | Brief Desciption |
|---|---|---|---|
| 1. | |||
| 2. | |||
| 3. | |||
| 4. | |||
| 5. |
School Districts are required by Federal Law and K.S.A. 72-6311 to protect the privacy rights of students under the age of 18.
Signed:____________________________________________________________ Administrator or other school employee.
cc: USD 443 Superintendent of Schools
Student/s file