High School Bullying/ITO Referral Form

High School Bullying - ITO (It Takes One) - Referral Form

The purpose of this form is to recommend a Cumberland Valley student who may need ITO friendship support.  This could be a new student, a student who is struggling or just someone who needs a friend! You can even refer yourself!

Additionally, you can use this form to make recommendations or suggestions to ITO for activity suggestions, questions or concerns about the club.  This can also be used to recognize someone who has made a good choice or taken a stand against bullying!

High School Bullying - ITO (It Takes One) - Referral Form

The purpose of this form is to recommend a Cumberland Valley student who may need ITO friendship support. This could be a new student, a student who is struggling or just someone who needs a friend! You can even refer yourself!

Additionally, you can use this form to make recommendations or suggestions to ITO for activity suggestions, questions or concerns about the club. You can also use this form to acknowledge a person who has made a good choice and/or taken a stand against bullying!

 

Name of student(s) you'd like to refer:
 
Reason you think they may benefit from support:
 
ITO concerns and suggestions to improve:
 
Your name and contact information (optional):
 
Is there anyone you know who has taken a stand or made a positive choice that will affect the culture at CV? If so we would like to recognize that person. Please list the person's name and describe the positive choice he/she made.
 


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