Oakmont Baptist Church Working With Minors Incident ... - Clover Sites

Oakmont     Baptist  Church     Date  of  Incident      

Working   W ith   M inors   Incident   R eport   F orm    

Name  of  Volunteer      

 

Area  of  Ministry      

 

Describe  what  was  seen  or  heard  that  cause  a  concern  to  a  possible  violation  of  the   Working  with  Minors  Policy    

 

 

 

 

 

 

 

Minor  Being  Supervised      

 

Witness(es)  to  the  Incident      

 

Person  Making  Report      

 

Staff  Member  Receiving  Report      

 

Date  Staff  Received  Report      

 

Date  Report  Filed  with  Business  Administrator      

 

Course  of  Action      

 

 

  Working  with  Minors  Incident  Report  Form  (02-­‐2015)   1