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ESSER III
Enrollment Information
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Threat Assessment Form
Threat Assessment Form
Date of Threat
*
Answer Required
Person completing form
*
Answer Required
Staff/Non-staff
*
Email
Answer Required
Phone number
*
Number Required
Time of Report
*
Answer Required
Campus Location
*
(Ex. Prichard, Scyene, Cedar Hill)
Answer Required
Type of Threat
*
Answer Required
Bomb Threat
Personal Injury
Burglary
Computer Cyber Crime
Fire / Fire Alarm
Vandalism
Other:
Who has been notified?
Answer Required
Police
Fire Department
Parent / Guardian
School Personnel
Who was involved?
Status
*
Answer Required
Student
Employee
Visitor
Unknown
Person 1 name
*
Answer Required
Person 1 Contact Information
*
Answer Required
Person 2 name
Answer Required
Person 2 Contact Information
Answer Required
Describe the threat
*
(What was said or demands)
Answer Required
Confirmation Email
Confirmation Email
Email Required
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