Kistler Elementary School | Ssc Employee Portal

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Incident Report
(Kistler Elementary School)

301 Old River Rd Wilkes-Barre, PA 18702

Please take a moment to fill out the form.

Date (MM/DD/YYYY) * required

Time (00:00am/pm)

Location of incident

Incident Type

If you selected Others

Report prepared by (ENTER YOUR FIRST AND LAST NAME)

Name of Victims/Subject/Suspect

Name of the SSCI Officers

Department/Agency

Name of Emergency Personnel (i.e PD. Officer Smith)

What took place (Who, what, where, when, why and how?) PLEASE PUT IN DETAILS WHAT HAPPENED IN 3RD PERSON?

Other Pertinent Information:

Photo

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