Anonymous Report Form -"See Something, Say Something"
If you use this form you will not be able to upload documents/photos.  If you want to upload documents/photos you must use the other Report Form where it will collect your email address.
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Check whether you are: *
Check whether you are: *
Nature of concern (Check all that apply): Please refer to definitions on website *
Required
Date of Incident(s):
MM
/
DD
/
YYYY
Time the Incident(s) Occurred? *
Time
:
Location of Incident(s) (Check all that apply):
Please further specify location:
Who is the victim? (Please list the first and last names and grade levels of all victims involved - to the best of your ability)
Describe the details of the incident *(Include the names of people involved (including witnesses), what occurred, and what each person did and said, including specific words used or actions taken).  
Has this happened before?
Clear selection
If yes, please describe previous incident(s):
Is there any physical evidence?(Check all that apply)
Is there any other information we need to know?
Person Filling Out Report:
Optional - enter your name below. (Note: Per Minnesota Statute, no disciplinary action will be taken against an alleged aggressor solely on the basis of an anonymous report)
Contact Information:
(Optional - add your phone number or any additional information which may be useful in the event we need to contact you)
Submit
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This form was created inside of Centennial ISD 12. Report Abuse
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