Survivors Turned Witnesses

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

FORM INSTRUCTIONS:

1. This is an effort to record instances of student mistreatment at TTI facilities/Christian Boarding Schools/Reform Schools).

2. Choose to report mistreatment that you WITNESSED, EXPERIENCED or BOTH. Choose to remain anonymous. Or don't.

3. Some former students could spend days or weeks submitting reports via this tool. And that's ok. Take your time and do what you gotta do.

4. Start with your most vividly recollected story.

5. If you know of a student who is CURRENTLY being mistreated at a facility, please call the state's Child Abuse Hotline and report it ASAP. In Missouri, callers can remain anonymous.

6. Remember this: Once we are released from hell, a lot of our buddies are still in there. So let's sit down, write out all the events we can remember during which staff caused harm to a student. Report each event to the state's child abuse hotline. One. By. One. Click this link to get started: https://dss.mo.gov/cd/keeping-kids-safe/can.htm

If it's determined that public disclosure of all or part of your submission is in the public interest, we will redact survivors' personal data identifiers before publishing.

What is your name?

You can use a real name or a fake name

Where would you like your story to be shared?

Medium.com

With a news organization

With participants in the Agape Homies Facebook Group

With parents of currently enrolled students

With law enforcement or child protective services

Can we email you or call you if we have follow-up questions? If so, enter your contact information here:

What do you want to do?

Report an event

Share my story

Clear selection

What year(s) were you at Agape? *

If you can remember the month or day or season in which this event occurred, enter that information here:

Where did this event occur? Please be as specific as you can. Include the name of the school. *

Example: Agape Boarding School, Stockton, MO, just outside of the Bucky Tucker dorm.

First and Last Name(s) of Event Perpetrator(s) *

Perpetrator: a person who carries out a harmful, illegal, or immoral act.

First and Last Name(s) of Mistreated Student(s) *

We won't release any student names unless it's ordered by a court, but please use discretion when deciding whether to enter the student's real name. You can use initials, first name only, or include a general description of the student ex. (15yo male student, short in stature but very loud-mouthed)

Event type (check all that apply) *

Physical assault

Psychological Manipulation

Hitting, slapping or punching a student

Jurassic Elbow

Concussion

Intentional Dehydration

Suffocation/Asphyxiation by immersion in liquid or vomit, or by smothering.

Strangling (choking)

Throwing a student into OR through a hard or sharp surface (side of building, wall, pile of rocks)

Prolonged grueling physical activity

Prolonged grueling physical labor (doing work that most people would expect to be paid for)

Pressure point attacks/muscular gouging

Stress position or submission position leading to extreme pain

Prolonged stress position or submission position leading to extreme pain and muscle failure

Speech Suppression ("No Talking" status)

Assault with wooden paddle or other punishment instrument

Ear witness to violence or torture as evidenced by audible screaming, shrieking, crying, or other signs of extreme pain

Excessive isolation at "The Wall"

Withholding food and/or water at designated meal times

Sexual Harrassment

Sexual Assault

Staff inciting, encouraging, ignoring, or compelling student-on-student violence

Staff on student bullying

Staff inciting, encouraging, ignoring or compelling student-on-student bullying

Torture in the Agape Boarding School "padded palace"

Forced urination suppression

Forced defecation suppression

Other:

Required

In your own words, what happened?

Pro Tip: Time order words can expedite your writing efforts: https://www.carrollk12.org/instruction/curriculum/elementary/ila/teachers/Documents/Time%20Order%20Words%205.15.15.pdf

Were there additional witnesses?

What ideas or suggestions do you have that might help eliminate or mitigate boarding school abuse?

(Optional) Your Name:

(Optional) If we have follow up questions, please let us know how we can contact you.

This is not required. Remain anonymous by skipping this question.

Submit

Clear form

Never submit passwords through Google Forms.

This form was created inside of Brutus Partners. Report Abuse

Forms