AEA INCIDENT REPORTING FORM
It is best to fill out this form
as soon as possible after the incident so it is fresh in your mind.
NAME______________________________________________
SCHOOL____________________________________
DATE & TIME OF
INCIDENT_______________________________________
LOCATION OF INCIDENT
(BE SPECIFIC)_________________________________________________
PERSON (S) INVOLVED _____________________________________
_____________________________________
_____________________________________
WITNESSES IF ANY _____________________________________
_____________________________________
_____________________________________
If this is grieveable do you
want to proceed? _____YES _____NO
(If you choose yes we must
have this form within 10 days of the incident so we can process it and meet the
required timelines for grievances)
Please explain
incident in your own words. If more space is needed you can continue on the
back of this form and/or on additional paper.