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<br />OCDSB 515-Part II Acknowledgement School Operations (May 2010) <br /> <br /> <br />SAFE SCHOOLS INCIDENT REPORTING FORM – PART II OF II <br />(References: Bill 157: Education Amendment Act (Keeping Our Kids Safe <br />at School Act), 2009 <br />Ministry of Education Policy and Program Memoranda (PPM) 144 and 145 <br />OCDSB Policies P.020.SCO, P.026.SCO and <br />Procedures PR.511.SCO and PR.515.SCO) <br /> <br />Reference the above-noted policies and procedures and page three for background and instructions on completing this form, <br />responsibilities of individual reporting the incident / activity and the principal, and distribution requirements as set out in the <br />Ministry of Education’s PPM 144 and 145. <br /> <br />Additional documentation / information relating to the incident may be attached to this form if required. <br />CONFIDENTIAL <br /> <br />SAFE SCHOOLS INCIDENT REPORTING FORM – PART II <br /> <br />ACKNOWLEDGEMENT OF RECEIPT OF REPORT <br /> <br /> <br /> <br />Report No: ________________________________________________________________________________ <br /> <br /> <br />Report Submitted By: Name: _______________________ Date: _____________________________ <br /> <br /> <br /> Action Taken No Action Required <br /> <br /> <br /> <br /> <br /> <br /> <br />Name of Principal: _________________________________ <br /> <br /> <br /> <br />Signature:_____________________________ Date: _____________ <br /> (Original signature is required) <br /> <br /> <br /> <br /> <br /> <br />Note: Only Part II is to be given to the person who submitted the report. <br /> <br />