Self Report

Use by School Personnel Only. This is to report a ...

What policy or bylaw are affected

Provide a description of the circumstances leading to the reported violation; Provide the name of the student and/or coach (if applicable)

List the contest(s) in which the student participated (if applicable); also indicate if the result of the contest was a "win"

List any corrective actions taken or NONE if applicable.

You acknowledge that all the information on this form is accurate by typing your name here

Your phone for followup information

This question is intended to prevent automated spam submissions.
5 + 7 =
Solve this simple math problem and enter the result. E.g. for 1+3, enter 4.