CPS Reporting
1 (800) 800-5556
Email
*
example@example.com
How Many Children Were Included in the Report?
*
Please Select all TCSC Buildings where involved students are enrolled:
*
Tipton Elementary School
Tipton Middle School
Tipton High School
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Child Information
1 (800) 800-5556
Child First and Last Name
*
First Name
Last Name
Role in Incident
*
Please Select
Not Involved
Involved
Victim
Date of Birth
-
Month
-
Day
Year
Date
Age of Child
*
TCSC School Where Student is Enrolled
*
Please Select
Tipton Elementary School
Tipton Middle School
Tipton High School
Sex
*
Please Select
Male
Female
Race
*
Please Select
White
African-American
Hispanic
Other
Current Location
*
Second Child Information
Child First and Last Name
*
First Name
Last Name
Role in Incident
*
Please Select
Not Involved
Involved
Victim
Date of Birth
-
Month
-
Day
Year
Date
Age of Child
*
TCSC School Where Student is Enrolled
*
Please Select
Tipton Elementary School
Tipton Middle School
Tipton High School
Sex
*
Please Select
Male
Female
Race
*
Please Select
White
African-American
Hispanic
Other
Current Location
*
Third Child Information
Child First and Last Name
*
First Name
Last Name
Role in Incident
*
Please Select
Not Involved
Involved
Victim
Date of Birth
-
Month
-
Day
Year
Date
Age of Child
*
TCSC School Where Student is Enrolled
*
Please Select
Tipton Elementary School
Tipton Middle School
Tipton High School
Sex
*
Please Select
Male
Female
Race
*
Please Select
White
African-American
Hispanic
Other
Current Location
*
Fourth Child Information
Child First and Last Name
*
First Name
Last Name
Role in Incident
*
Please Select
Not Involved
Involved
Victim
Date of Birth
-
Month
-
Day
Year
Date
Age of Child
*
TCSC School Where Student is Enrolled
*
Please Select
Tipton Elementary School
Tipton Middle School
Tipton High School
Sex
*
Please Select
Male
Female
Race
*
Please Select
White
African-American
Hispanic
Other
Current Location
*
Five+ Children Information
Please input all information below for all children in report, including: Name, Date of Birth, Age, Grade Level, Sex, Race, Current Location
*
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Guardian Information
1 (800) 800-5556
Parent/Guardian Description
Parent/Guardian First and Last Name
*
First Name
Last Name
Relationship to Student
*
Please Select
Father
Mother
Guardian
Role in Incident
*
Please Select
Involved
Not Involved
Date of Birth
-
Month
-
Day
Year
Date
Sex
*
Please Select
Male
Female
Race
*
Please Select
White
African-American
Hispanic
Other
Address (Including Street, City, State, Zip)
*
Phone Number
*
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Alleged Perpetrator (Other than parent or Guardian)
If not Applicable, please select "Next" to proceed to next step.
Alleged Perpetrator First and Last Name
First Name
Last Name
Date of Birth
-
Month
-
Day
Year
Date
Sex
Please Select
Male
Female
Race
Please Select
White
African-American
Hispanic
Other
Address (Including Street, City, State, Zip)
Phone Number
Relationship to Student
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Nature of Complaint
Allegations
*
Allegation Narrative
*
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DCS Report
Please complete the information below regarding your DCS Report
Date Reported
*
-
Month
-
Day
Year
Date
Time Reported
*
Hour Minutes
AM
PM
AM/PM Option
Witness Name
*
First Name
Last Name
Hotline Agent Name
*
First Name
Last Name
Case Number
*
Submit
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