Wufoo
Safe Schools Anti-bullying Initiative - Member reg
Safe Schools Anti-bullying Initiative - Member registration
School details
School Name
*
Principal name:
First
Last
Key contact
Name
*
First
Last
Role
Phone Number
Email
Governing council endorsement
Chair name:
*
First
Last
Governing council endorsement Y/N
Yes
No
School community informed: (not required prior to submitting form)
Yes
No
If No, the expected completion date is:
MM
/
DD
/
YYYY
Evaluation
I grant approval for school harassment and wellbeing data to be accessed centrally for the evaluation of the initiative :
Yes
No
Support required
Check All That Apply
General same sex attracted, intersex or gender diverse (SSAIGD) information
Policy /procedure advice and/or implementation
Support with governing council and/or community consultation
Support for an individual SSAIGD student
Targeted presentations
Professional development
Next steps planning
Support with establishing a gay/straight alliance group
On-site attendance by SHINE SA
Targeted presentations - Check All That Apply
leadership
governing council
staff meeting
Professional development - Check All That Apply
leadership
whole staff
other (details)
On-site attendance by SHINE SA - Check All That Apply
support for a gay/straight alliance group
attendance at whole of school event eg wellbeing day, IDAHOT
other …………….
Do Not Fill This Out
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