Community Impact Statement

Your Name

Your Phone

Your Email

Do you want to participate further in the resolution of this incident?

Do you want to testify at this hearing? If you do, our staff will contact you

Please give a brief description of your involvement in this incident

Affect of this incident - How did this incident affect yourself, students, teachers, family, or other members of the community?

History of Incidents - Is there a history of similar incidents in this school, neighborhood or community?

Affect of similar incidents - If so, what have been the cumulative effects of these incidents?

Resolution - How do you think this incident should be resolved in a way that repairs relationships and builds community?

Any other testimony - Is there anything else you would like the Peer Court to consider?