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YOUR SCHOOL NAME HERE SAMPLE STUDENT HARASSMENT REFERRAL ACTION GENERAL INFORMATION Last Name: First: Date of Incident: Reported by: Time of Incident: Grade: Date of Referral: Title of Reporter: Location
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How to fill out student harassment referral action

How to fill out student harassment referral action
01
First, gather all the necessary information about the incident, including the date, time, and location.
02
Next, identify the individuals involved in the harassment and document their names and any relevant contact information.
03
Then, describe the nature of the harassment and the specific actions that took place.
04
Provide any supporting evidence, such as witness statements or photographs, if available.
05
Ensure that the referral form is filled out completely and accurately, including your own personal details as the person reporting the incident.
06
Submit the referral form to the appropriate authority or school officials responsible for handling student harassment cases.
07
Follow up with any additional information or documentation that may be requested during the investigation process.
08
Finally, keep track of any updates or outcomes related to the referral and be prepared to provide any further assistance if needed.
Who needs student harassment referral action?
01
Any student who has experienced harassment or witnessed harassment happening to another student.
02
School administrators who receive reports or complaints related to student harassment.
03
Teachers or faculty members who need to document incidents of student harassment.
04
Counselors or support staff who provide assistance to students affected by harassment.
05
Parents or guardians who want to report incidents of student harassment on behalf of their child.
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What is student harassment referral action?
Student harassment referral action is a formal process for reporting instances of harassment or bullying involving students.
Who is required to file student harassment referral action?
Any school staff member who witnesses or receives a report of student harassment is required to file the referral action.
How to fill out student harassment referral action?
The referral action form typically includes details of the incident, names of parties involved, date/time/location of the incident, and any supporting evidence.
What is the purpose of student harassment referral action?
The purpose of student harassment referral action is to address and respond to incidents of harassment or bullying in a timely and appropriate manner.
What information must be reported on student harassment referral action?
The referral action form must include detailed information about the incident, including names of individuals involved, date/time/location of the incident, and any witnesses or evidence.
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