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    Report-Of-Cases-Of-Abuse, Bullying, Violence, Etc... COT

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    oranisouth
    The document reports cases of abuse, violence, exploitation, discrimination, bullying or peer abuse from a school in the Philippines. It includes a form to gather information on victims, complaints, and respondents. The form requests details of incidents and actions taken as well as recommendations.

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    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd

    Report-Of-Cases-Of-Abuse, Bullying, Violence, Etc... COT

    Uploaded by

    oranisouth
    11 views3 pages
    The document reports cases of abuse, violence, exploitation, discrimination, bullying or peer abuse from a school in the Philippines. It includes a form to gather information on victims, complaints, and respondents. The form requests details of incidents and actions taken as well as recommendations.

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    Report-of-cases-of-abuse, bullying,violence,etc...COT.docx

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    The document reports cases of abuse, violence, exploitation, discrimination, bullying or peer abuse from a school in the Philippines. It includes a form to gather information on victims, complaints, and respondents. The form requests details of incidents and actions taken as well as recommendations.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    11 views3 pages

    Report-Of-Cases-Of-Abuse, Bullying, Violence, Etc... COT

    Uploaded by

    oranisouth
    The document reports cases of abuse, violence, exploitation, discrimination, bullying or peer abuse from a school in the Philippines. It includes a form to gather information on victims, complaints, and respondents. The form requests details of incidents and actions taken as well as recommendations.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
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    R E P U B L I C O F T HE P H I L I P P I N E S

    Department of Education
    R E G I O N III
    S C H O O L S D I VI S I O N O F F I CE O F B A T A AN
    SDO B AT A AN – O R AN I A N N E X
    PANTALAN LUMA ELEMENTARY SCHOOL

    Report of Cases of Abuse, Violence, Exploitation,


    Discrimination, Bullying or Peer Abuse and other related
    offenses
    School/ Division/ Region: _______________________________________
    Period Covered :________________________________________
    Person Submitting Report: _______________________________________
    Designation : _______________________________________ Date: _________________

    NAME AGE SEX NAME AGE SEX NATURE OF ACTION/S RECOMMEN


    (Victims) (M/F) Respondent/s (M/F) COMPLAINT TAKEN DATIONS
    DEPARTMENT OF EDUCATION
    INTAKE SHEET
    I. INFORMATION

    A. VICTIM:

    Name :__________________________________________________________

    Date of Birth : ______________________ Age :______ Sex : ____

    Grade : ______________________ Adviser : ________________

    Parents:

    Mother : _____________________ Age : _________

    Occupation : _____________________

    Address and Contact Number : __________________________________

    Father : ____________________ Age :_________

    Occupation : _____________________

    Address and Contact Number : __________________________________

    B. COMPLAINT:

    Name : __________________________________________________________

    Relationship to Victim : _____________________________

    Address and Contact Number : _____________________________

    C. RESPONDENT:

    C.1. If respondent is a School Personnel

    Name : ________________________________________________________________

    Date of Birth : ___________________ Age : _____ Sex :_____

    Designation/Position : ____________________________________________________

    Address and Contact Number : _____________________________________________

    C.2. If respondent is a student

    Name : ________________________________________________________________
    Date of Birth : ___________________ Age: ________ Sex:_______

    Grade _________________________ Adviser: _________________________

    Mother : ________________________________Age : _________

    Occupation: __________________________________________

    Address and Contact Number: ____________________________________

    Father : _________________________________Age :____________

    Occupation: _______________________________________

    Address and Contact Number: ____________________________________

    II. DETAILS OF THE CASE:

    III. ACTION TAKEN:


    1.
    2.
    3.
    4.

    IV. RECOMMENDATIONS:
    1.
    2.
    3.

    Prepared by:
    __________________________________________
    Name over Printed Name
    __________________________________________
    Designation
    __________________________________________
    Date

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