Incident Report

Staff Last Name *

Staff First Name *

Title *

Date of Incident * +

Time of Incident *

Describe in detail the incident(s) of reporting as clear as possible. Please include who, what, when, where, and why: *

Witnesses: Please list all witnesses as possible

Please upload any images that are part of this incident:

Staff Signature *

clear

Delano High School

Delano Joint Union High School District

Staff Incident Report

2019 | 2020