Name: __________________________________________________
Address: ________________________________________________
Sponsoring School: ________________________________________
*Fax or send each incident as it occurs. Please do not wait until the form is full before submitting.
| Date/Time | Location & Description/Action Taken or Assistance Given | Adult Volunteer & Child Involved |
| | | |
| | | |
| | | |
| | | |
Send completed form to:
Plano Police Department
Crime Prevention Unit
909 14th Street
Plano, TX 75074
Fax completed form to: (972) 941-2519