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Vaping Complaint Form

The purpose of Policy 5.46 Vaping is to establish a vape awareness, education, and prevention program to prohibit the possession and use of prohibited tobacco, tobacco products, electronic nicotine delivery systems, e-liquids, and alternative nicotine products by students in public K-12 schools.

Complaint Procedure – When a complaint is lodged against a student for violating the prohibition, the complaint must be memorialized using the approved complaint form.  An anonymous report may not be used as the sole basis for imposition of formal disciplinary action. Once a complaint is made against a student for a violation, the complaint form is then to be forwarded to the principal, assistant principal, or school resource officer for investigation.  The complaint form must include all of the following information:

  1. Name of student who has violated the policy.
  2. Date, time, and location of violation.
  3. Description of conduct that violates the policy.
  4. Name(s) of witness(es) to violation of the policy.
  5. Any other pertinent information.

The attached form should be completed and returned to the school principal.  

 

Vape, Tobacco, and Alternative Nicotine Complaint Form - English

Vape, Tobacco, and Alternative Nicotine Complaint Form - Spanish