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APPENDIX J: VIOLENT INCIDENT FORM
Violent Incident Form
Name of student
A. Description of Violent Incident
B. PoliceContact
1. Date of contact
C. School/Board Response
1. Suspension 2. Expulsion 3. Other
Date of inclusion in OSR Principal’s/designate’s signature
(Please refer to the document Violence-Free Schools Policy for direction on the removal of this form from the OSR.)
2. Date of police investigation at school
3. Name of investigating officer(s)
March 2000 39
