Student Issue Report

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Student Issue Report Form

Thank you for completing a Student Issue Report Form on behalf of a student enrolled at Ingomar Elementary School! This form is to be used to communicate information to the School Counselor and Principal. This information could be regarding conflict between students, potential bullying situations, changes in home or family dynamics, etc. We are always open to receiving phone calls and emails directly as well; however, it is our hope to make reporting issues as easy as possible. This is simply one more venue to ensure that your voice is heard and that the students are able to receive the assistance they need. Students are also able to come to both Mrs. Sweeney and Mrs. Silbaugh during the day or to leave notes for them in their respective offices. Many thanks!

1.	What is the first and last name of the child for whom you are entering this report?*

2.	In which grade is the child enrolled at Ingomar Elementary School?*

3.	What is your name?* Please enter your first and last name for future communications.

4.	Please enter your email below.*

5.	Please enter your phone number below.*

6.	Please describe the situation, which you want to report on behalf of the student at Ingomar Elementary School with as much detail as possible.* Your information will be sent directly to Mrs. Silbaugh & Mrs. Sweeney for review, via email. Calling the school directly can be a faster method of obtaining a response in the event that they are out of the office and unable to respond the day of your inquiry. Please follow up on any issues, about which you do not hear back, to ensure that the form has been received. We want to help work with you and your child to ensure an excellent educational experience.

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