"Safe and Caring Schools Incident Reporting Form - Toronto District School Board"

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Safe and Caring Schools Incident Reporting Form – Part I
REPORT
School Name
NO:
Name of Students
Involved (if known)
At a location in the school or on school property
At a school related activity ( specify)
Location of
(specify)
Other (specify)
Incident
On a School Bus (specify route number)
Date and Time
Incident Date:
Time:
Type of Incident (please check all that apply)
Suspension a Principal shall consider (Education Act, Part XIII, Section 306(1))
1. Uttering a threat to inflict serious bodily harm
4. Swearing at a teacher or at another person in a
on another person
position of authority
2. Possessing alcohol or illegal drugs
5. Committing an act of vandalism that causes
extensive damage to school property at the pupil's
school or to property located on the premises of the
3. Being under the influence of alcohol
pupil's school
6. Bullying
Suspensions that may be considered (Education Act, Part XIII, Section 306(1)(7))
1. Wilful destruction of school property;
vandalism causing damage to school or Board
10. Fighting
property or property located on school or Board
premises
2. Use of profane and improper language
11. Possession or misuse of any harmful substances
3. Use of tobacco
12. Hate motivated violence
4. Theft
13. Extortion
5. Aid/Incite harmful behaviour
14. Distribution of hate material
6. Physical Assault
15. Inappropriate use of electronic communication/media
7. Being under the influence of illegal drugs
16. An act considered by the Principal to be a breach of the
Board's or school's Code of Conduct:
8. Sexual harassment
Please specify the breach (30 characters max.)
9. Racial harassment
Suspension pending possible expulsions (Education Act, Part XIII, Section 310(1))
1. Possessing a weapon, including a firearm
5. Trafficking in weapons or in illegal drugs
2. Using a weapon to cause or to threaten
6. Committing robbery
bodily harm to another person
3. Committing physical assault on another
person that causes bodily harm requiring
7. Giving alcohol to a minor
treatment by a medical practitioner
4. Committing sexual assault
Suspension pending possible expulsions (Education Act, Part XIII, Section 310(1)(8))
2. An act considered by the Principal to be a Serious Breach
1. Possession of explosive substance
of the board's or school's code of conduct: please specify the
breach (30 characters max.)
Report Submitted By:
Name:
Signature:
Date:
Contact Information Location :
Telephone:
Safe and Caring Schools Incident Reporting Form – Part I
REPORT
School Name
NO:
Name of Students
Involved (if known)
At a location in the school or on school property
At a school related activity ( specify)
Location of
(specify)
Other (specify)
Incident
On a School Bus (specify route number)
Date and Time
Incident Date:
Time:
Type of Incident (please check all that apply)
Suspension a Principal shall consider (Education Act, Part XIII, Section 306(1))
1. Uttering a threat to inflict serious bodily harm
4. Swearing at a teacher or at another person in a
on another person
position of authority
2. Possessing alcohol or illegal drugs
5. Committing an act of vandalism that causes
extensive damage to school property at the pupil's
school or to property located on the premises of the
3. Being under the influence of alcohol
pupil's school
6. Bullying
Suspensions that may be considered (Education Act, Part XIII, Section 306(1)(7))
1. Wilful destruction of school property;
vandalism causing damage to school or Board
10. Fighting
property or property located on school or Board
premises
2. Use of profane and improper language
11. Possession or misuse of any harmful substances
3. Use of tobacco
12. Hate motivated violence
4. Theft
13. Extortion
5. Aid/Incite harmful behaviour
14. Distribution of hate material
6. Physical Assault
15. Inappropriate use of electronic communication/media
7. Being under the influence of illegal drugs
16. An act considered by the Principal to be a breach of the
Board's or school's Code of Conduct:
8. Sexual harassment
Please specify the breach (30 characters max.)
9. Racial harassment
Suspension pending possible expulsions (Education Act, Part XIII, Section 310(1))
1. Possessing a weapon, including a firearm
5. Trafficking in weapons or in illegal drugs
2. Using a weapon to cause or to threaten
6. Committing robbery
bodily harm to another person
3. Committing physical assault on another
person that causes bodily harm requiring
7. Giving alcohol to a minor
treatment by a medical practitioner
4. Committing sexual assault
Suspension pending possible expulsions (Education Act, Part XIII, Section 310(1)(8))
2. An act considered by the Principal to be a Serious Breach
1. Possession of explosive substance
of the board's or school's code of conduct: please specify the
breach (30 characters max.)
Report Submitted By:
Name:
Signature:
Date:
Contact Information Location :
Telephone:
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