JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
SEE SOMETHING. SAY SOMETHING.
At National School District, we encourage all students, parents and staff to speak up when they see something that seems dangerous or inappropriate.
Please use the form below to report suspicious activity or wrongdoing.
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Name (optional)
Your answer
Phone (optional)
Your answer
Email (optional)
Your answer
School Site / Location
*
Choose
Central Elementary
El Toyon Elementary
Ira Harbison Elementary
Kimball Elementary
Las Palmas Elementary
Lincoln Acres Elementary
Olivewood Elementary
John Otis Elementary
Palmer Way Elementary
Rancho De La Nacion Elementary
District Office
When did the incident occur?
*
MM
/
DD
/
YYYY
What type of incident are you reporting
*
Choose
Bullying
Threat
Vandalism
Suspicious Activity
Drug Activity
Dangerous Behavior
Concern for Safety
Other (please describe in box below)
Where did this incident take place?
*
Your answer
If the incident is happening on social media, which platform?
Your answer
Please give a brief description regarding what you know about the situation what happened or has been occurring.
*
Your answer
Name of the Suspect (Person who is bullying or causing the incident. If you do not know the person's name, please leave this answer blank.)
Your answer
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of National School District.
Report Abuse
Forms