{"id":1761,"date":"2019-02-12T10:58:01","date_gmt":"2019-02-12T16:58:01","guid":{"rendered":"https:\/\/adc.d211.info\/forms\/?page_id=1761"},"modified":"2019-02-12T14:14:59","modified_gmt":"2019-02-12T20:14:59","slug":"fremd-high-school-safety-concern","status":"publish","type":"page","link":"https:\/\/adc.d211.info\/forms\/fremd-high-school-safety-concern\/","title":{"rendered":"Fremd High School Safety Concern"},"content":{"rendered":"<p><img loading=\"lazy\" class=\"alignnone size-large wp-image-1776\" src=\"https:\/\/adc.d211.info\/forms\/wp-content\/uploads\/2019\/02\/Screen-Shot-2019-02-12-at-11.01.05-AM-1024x140.png\" alt=\"Fremd High School Safety Concern\" width=\"840\" height=\"115\" srcset=\"https:\/\/adc.d211.info\/forms\/wp-content\/uploads\/2019\/02\/Screen-Shot-2019-02-12-at-11.01.05-AM-1024x140.png 1024w, https:\/\/adc.d211.info\/forms\/wp-content\/uploads\/2019\/02\/Screen-Shot-2019-02-12-at-11.01.05-AM-300x41.png 300w, https:\/\/adc.d211.info\/forms\/wp-content\/uploads\/2019\/02\/Screen-Shot-2019-02-12-at-11.01.05-AM-768x105.png 768w, https:\/\/adc.d211.info\/forms\/wp-content\/uploads\/2019\/02\/Screen-Shot-2019-02-12-at-11.01.05-AM-1200x164.png 1200w, https:\/\/adc.d211.info\/forms\/wp-content\/uploads\/2019\/02\/Screen-Shot-2019-02-12-at-11.01.05-AM.png 1728w\" sizes=\"(max-width: 709px) 85vw, (max-width: 909px) 67vw, (max-width: 1362px) 62vw, 840px\" \/><\/p>\n<form method=\"post\" enctype=\"multipart\/form-data\" id=\"vfbp-form-127\" class=\"vfbp-form\"><div style=\"display:none;\"><label for=\"vfbp-EMAIL-AN8fuQyoDLXem\">If you are human, leave this field blank.<\/label><input size=\"25\" autocomplete=\"off\" type=\"text\" name=\"vfbp-EMAIL-AN8fuQyoDLXem\" value=\"\" id=\"\"><\/div><input type=\"hidden\" name=\"_vfb-timestamp-127\" value=\"1775279791\" id=\"\"><input type=\"hidden\" name=\"_vfb-form-id\" value=\"127\" id=\"\"><div class=\"vfb-form-group vfb-col-12\"><div><div class=\"\">Safety Concern Center for Fremd High School<\/div><span class=\"vfb-help-block\">If you or someone you know has experienced harassment, bullying, discrimination, sexual harassment, dating violence, or any other prohibited conduct, school staff will help. Although we encourage reports to be made to an administrator, student services personnel, police consultant, or a trusted adult, students may instead submit a Safety Concern Report.\r\n<\/br><\/br>\r\nThese reports can be anonymous; however, sometimes our staff is able to respond, assist, and in some instances intervene quicker when the reporter shares their identity. We encourage reporters to include their name and\/or contact information. Every effort will be made to protect the identity of the individual making the report if not submitted anonymously.\r\n<\/br><\/br>\r\nThe Safety Concern Report also should be used to report any concerning matters of school, individual, or public safety. Any reports of concerns for safety should include as many specific details as possible. All reports that are submitted are immediately routed to administrators; however, if you are experiencing an emergency or need immediate assistance, please call 911.<\/span><\/div><\/div><div class=\"vfb-col-12 vfb-fieldType-heading\" id=\"vfbField4879\"><\/div><div class=\"vfb-clearfix\"><\/div><div class=\"vfb-col-12 vfb-fieldType-text\" id=\"vfbField4880\"><div class=\"vfb-form-group\"><label for=\"vfb-field-4880\" class=\"vfb-control-label\">Full Name<\/label><div><input id=\"vfb-field-4880\" class=\"vfb-form-control\" placeholder=\"\" type=\"text\" name=\"vfb-field-4880\" value=\"\"><\/div><\/div><\/div><div class=\"vfb-clearfix\"><\/div><div class=\"vfb-col-12 vfb-fieldType-email\" id=\"vfbField4881\"><div class=\"vfb-form-group\"><label for=\"vfb-field-4881\" class=\"vfb-control-label\">Email<\/label><div><input id=\"vfb-field-4881\" class=\"vfb-form-control\" placeholder=\"\" type=\"email\" name=\"vfb-field-4881\" value=\"\"><\/div><\/div><\/div><div class=\"vfb-clearfix\"><\/div><div class=\"vfb-col-12 vfb-fieldType-radio\" id=\"vfbField4882\"><label for=\"vfb-field-4882\" class=\"vfb-control-label\">Select One... <span class=\"vfb-required-asterisk\">*<\/span><\/label><div><div class=\"vfb-radio\"><label><input id=\"vfb-field-4882-0\" class=\"\" placeholder=\"\" required=\"required\" type=\"radio\" name=\"vfb-field-4882\" value=\"Student\">Student<\/label><\/div><div class=\"vfb-radio\"><label><input id=\"vfb-field-4882-1\" class=\"\" placeholder=\"\" required=\"required\" type=\"radio\" name=\"vfb-field-4882\" value=\"Parent\">Parent<\/label><\/div><div class=\"vfb-radio\"><label><input id=\"vfb-field-4882-2\" class=\"\" placeholder=\"\" required=\"required\" type=\"radio\" name=\"vfb-field-4882\" value=\"Community Member\">Community Member<\/label><\/div><div class=\"vfb-radio\"><label><input id=\"vfb-field-4882-3\" class=\"\" placeholder=\"\" required=\"required\" type=\"radio\" name=\"vfb-field-4882\" value=\"If other, please specify\">If other, please specify<\/label><\/div><div class=\"vfb-radio\"><label><input id=\"vfb-field-4882-4\" class=\"\" placeholder=\"\" type=\"radio\" name=\"vfb-field-4882\" value=\"\"><input class=\"vfb-form-control\" id=\"vfb-field-4882-other\" type=\"text\" name=\"vfb-field-4882-other\" value=\"\"><\/label><\/div><\/div><\/div><div class=\"vfb-clearfix\"><\/div><div class=\"vfb-col-12 vfb-fieldType-text\" id=\"vfbField4883\"><div class=\"vfb-form-group\"><label for=\"vfb-field-4883\" class=\"vfb-control-label\">DATE OF INCIDENT (specific date, or date range): If you know specifically, the date and time, please indicate here <span class=\"vfb-required-asterisk\">*<\/span><\/label><div><input id=\"vfb-field-4883\" class=\"vfb-form-control\" placeholder=\"\" required=\"required\" type=\"text\" name=\"vfb-field-4883\" value=\"\"><\/div><\/div><\/div><div class=\"vfb-clearfix\"><\/div><div class=\"vfb-col-12 vfb-fieldType-text\" id=\"vfbField4884\"><div class=\"vfb-form-group\"><label for=\"vfb-field-4884\" class=\"vfb-control-label\">CONCERN DESCRIPTION: Be specific. Include all relevant details including names, dates, locations, and other information describing the concern. <span class=\"vfb-required-asterisk\">*<\/span><\/label><div><input id=\"vfb-field-4884\" class=\"vfb-form-control\" placeholder=\"\" required=\"required\" type=\"text\" name=\"vfb-field-4884\" value=\"\"><\/div><\/div><\/div><div class=\"vfb-clearfix\"><\/div><div class=\"vfb-col-12 vfb-fieldType-file-upload\" id=\"vfbField4885\"><div class=\"vfb-form-group\"><label for=\"vfb-field-4885[]\" class=\"vfb-control-label\">Attach document(s) or photo(s) related to your concern.<\/label><div><input id=\"vfb-field-4885\" class=\"vfb-form-control vfb-file-input\" placeholder=\"\" data-max-file-count=\"5\" data-allowed-file-extensions=\"pdf,jpg,png,\" data-show-preview=\"false\" multiple=\"1\" type=\"file\" name=\"vfb-field-4885[]\"><\/div><\/div><\/div><div class=\"vfb-clearfix\"><\/div><div class=\"vfb-col-12 vfb-fieldType-instructions\" id=\"vfbField4886\"><div class=\"vfb-form-group\"><label for=\"vfb-field-4886\" class=\"vfb-control-label\"><\/label><div class=\"\"><p>By submitting this form, I certify that this report is accurate and factual to the best of my knowledge, and know that submitting false or fraudulent information may result in disciplinary action or referral to law enforcement officials.<\/p>\n<\/div><\/div><\/div><div class=\"vfb-clearfix\"><\/div><div class=\"vfb-col-12 vfb-fieldType-date\" id=\"vfbField4888\"><div class=\"vfb-form-group\"><label for=\"vfb-field-4888\" class=\"vfb-control-label\">Date<\/label><div><input id=\"vfb-field-4888\" class=\"vfb-form-control\" placeholder=\"\" data-provide=\"datepicker\" type=\"text\" name=\"vfb-field-4888\" value=\"\"><\/div><\/div><\/div><div class=\"vfb-clearfix\"><\/div><div class=\"vfb-col-12 vfb-fieldType-submit\" id=\"vfbField4887\"><button id=\"vfb-field-4887\" class=\" btn btn-primary\" placeholder=\"\" type=\"submit\" name=\"_vfb-submit\">Submit<\/button><\/div><div class=\"vfb-clearfix\"><\/div><\/form>\n","protected":false},"excerpt":{"rendered":"","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":[],"_links":{"self":[{"href":"https:\/\/adc.d211.info\/forms\/wp-json\/wp\/v2\/pages\/1761"}],"collection":[{"href":"https:\/\/adc.d211.info\/forms\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/adc.d211.info\/forms\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/adc.d211.info\/forms\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/adc.d211.info\/forms\/wp-json\/wp\/v2\/comments?post=1761"}],"version-history":[{"count":3,"href":"https:\/\/adc.d211.info\/forms\/wp-json\/wp\/v2\/pages\/1761\/revisions"}],"predecessor-version":[{"id":1796,"href":"https:\/\/adc.d211.info\/forms\/wp-json\/wp\/v2\/pages\/1761\/revisions\/1796"}],"wp:attachment":[{"href":"https:\/\/adc.d211.info\/forms\/wp-json\/wp\/v2\/media?parent=1761"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}