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Forms US_GA_CSD IncidentReport
Route
Run
Driver
Driver
Student Name
Student Last Name
Student First Name
Gender
Grade
School
Date & Time of Misconduct
REASON FOR REPORT
fighting on the bus
eating or drinking on the bus
throwing objects
being late for pickup
yelling or talking loudly
possessing and/or using alcohol or drugs
using inappropriate language or gestures
littering the bus
disobeying the driver's instruction
causing wilful damage
teasing or harassing others (verbally or physically)
projecting parts of body out of window
entering/exiting bus in a disruptive manner
playing around bus or bus stop
standing/moving about the bus while it is in motion
throwing objects at, in or from bus
blocking the aisle
sitting in an unauthorized seat
playing with distracting object
unauthorized opening of doors, windows or emergency equipment
carrying oversize object or equipment
entering/exiting at an undesignated stop without permission
smoking or lighting matches
Others (specify in comments)
Action taken (Select all that apply)
Conference with student
Speak to child w/a third party present and reassign seat
Communicated with parents
Submit to administrator
Comments:
Details and comments (if required):
Incident Report #:
1
2
3
4
5
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9
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13
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20
Administrative Action
--Select--
Warning
In-school consequence
Day bus privileges suspended
Loss of privilege of bus travel - 3 school days
Loss of privilege of bus travel - 8 school days
Loss of privilege of bus travel - Indefinitely
Submitted by
Last Name
First Name
Email
Confidentiality Statement
In accordance with the Personal Information Protection and Electronic Documents Act, Article 29, Paragraph (2), personal information requested in this form will assist in providing transportation services. The information is gathered in accordance with the Education Act S.R.O. 1980, c. 129, s.166 (1).
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