{"id":4790,"date":"2020-06-24T03:13:17","date_gmt":"2020-06-24T03:13:17","guid":{"rendered":"https:\/\/www.rossmoyneshs.wa.edu.au\/forms\/?page_id=4790"},"modified":"2023-09-13T03:33:13","modified_gmt":"2023-09-13T03:33:13","slug":"anonymous-online-report-of-a-concern-for-a-rossmoyne-shs-student","status":"publish","type":"page","link":"https:\/\/www.rossmoyneshs.wa.edu.au\/forms\/?page_id=4790","title":{"rendered":"Anonymous Online Report of a Concern for a Rossmoyne SHS Student Year 11 or Year 12"},"content":{"rendered":"<form method=\"post\" enctype=\"multipart\/form-data\" id=\"vfbp-form-38\" class=\"vfbp-form\"><div style=\"display:none;\"><label for=\"vfbp-EMAIL-AN8fuQyoDLXem\">If you are human, leave this field blank.<\/label><input size=\"25\" autocomplete=\"off\" type=\"text\" name=\"vfbp-EMAIL-AN8fuQyoDLXem\" value=\"\" id=\"\"><\/div><input type=\"hidden\" name=\"_vfb-timestamp-38\" value=\"1781938713\" id=\"\"><input type=\"hidden\" name=\"_vfb-form-id\" value=\"38\" id=\"\"><div class=\"vfb-form-group vfb-col-12\"><div><div class=\"\"><\/div><span class=\"vfb-help-block\"><h3><strong>Because iCARE<\/strong><\/h3>\r\n<h6>Concern relating to a Year 11 or a Year 12 student student<\/h6>\r\nAnonymous Online Report of a Concern for a Rossmoyne SHS Student<\/span><\/div><\/div><div class=\"vfb-col-12 vfb-fieldType-heading\" id=\"vfbField967\"><\/div><div class=\"vfb-clearfix\"><\/div><div class=\"vfb-col-12 vfb-fieldType-instructions\" id=\"vfbField970\"><div class=\"vfb-form-group\"><label for=\"vfb-field-970\" class=\"vfb-control-label\">The information you are supplying is about someone you are genuinely concerned about. It is important that you are truthful and responsible. <\/label><div class=\"\"><\/div><\/div><\/div><div class=\"vfb-clearfix\"><\/div><div class=\"vfb-col-12 vfb-fieldType-instructions\" id=\"vfbField981\"><div class=\"vfb-form-group\"><label for=\"vfb-field-981\" class=\"vfb-control-label\">Your notification is anonymous which means we will not know who makes this report unless you choose to include your name.<\/label><div class=\"\"><p class=\"x_MsoNormal\"><b>Please note: if your report requires urgent attention please redirect your concerns as below as these reports are not monitored outside of school hours<\/b><\/p>\n<p class=\"x_MsoNormal\"><b>\u00a0<\/b><b>If you are concerned for someone\u2019s immediate safety<\/b><b> <\/b><b>call 000. If you yourself need urgent support, call Lifeline&#8217;s 13 11 14 crisis support service which is available 24\/7.<\/b><\/p>\n<p class=\"x_MsoNormal\"><b>\u00a0<\/b><b>A list of supports for less urgent concerns, over weekends or during holidays, can be accessed via SEQTA using the <a href=\"https:\/\/learn.rossmoyneshs.wa.edu.au\/#?page=\/portals\/f93a9bf7-0650-40db-8d4a-16e025ffac0c\">Student Central Portal<\/a>.\u00a0 <\/b><\/p>\n<\/div><\/div><\/div><div class=\"vfb-clearfix\"><\/div><div class=\"vfb-col-4 vfb-fieldType-text\" id=\"vfbField973\"><div class=\"vfb-form-group\"><label for=\"vfb-field-973\" class=\"vfb-control-label\">Name of the student you are concerned about  <span class=\"vfb-required-asterisk\">*<\/span><\/label><div><input id=\"vfb-field-973\" class=\"vfb-form-control\" placeholder=\"\" required=\"required\" type=\"text\" name=\"vfb-field-973\" value=\"\"><\/div><\/div><\/div><div class=\"vfb-col-4 vfb-fieldType-select\" id=\"vfbField974\"><label for=\"vfb-field-974\" class=\"vfb-control-label\">This report is about: <span class=\"vfb-required-asterisk\">*<\/span><\/label><div><div class=\"vfb-form-group\"><select id=\"vfb-field-974\" class=\"vfb-form-control\" placeholder=\"\" required=\"required\" name=\"vfb-field-974\"><option value=\"Bullying\">Bullying<\/option><option value=\"Cyberbullying\">Cyberbullying<\/option><option value=\"Discrimination\">Discrimination<\/option><option value=\"Family\/domestic violence\">Family\/domestic violence<\/option><option value=\"Physical fight\">Physical fight<\/option><option value=\"Illegal activity\">Illegal activity<\/option><option value=\"Self-harm\">Self-harm<\/option><option value=\"Suicidal thoughts\">Suicidal thoughts<\/option><option value=\"Sexual harassment\/abuse\">Sexual harassment\/abuse<\/option><option value=\"Vandalism\">Vandalism<\/option><option value=\"Something is broken\">Something is broken<\/option><option value=\"Other\">Other<\/option><\/select><\/div><\/div><\/div><div class=\"vfb-col-4 vfb-fieldType-select\" id=\"vfbField972\"><label for=\"vfb-field-972\" class=\"vfb-control-label\">What year are they in? <span class=\"vfb-required-asterisk\">*<\/span><\/label><div><div class=\"vfb-form-group\"><select id=\"vfb-field-972\" class=\"vfb-form-control\" placeholder=\"\" required=\"required\" name=\"vfb-field-972\"><option value=\"11\">11<\/option><option value=\"12\">12<\/option><\/select><\/div><\/div><\/div><div class=\"vfb-clearfix\"><\/div><div class=\"vfb-col-12 vfb-fieldType-textarea\" id=\"vfbField975\"><div class=\"vfb-form-group\"><label for=\"vfb-field-975\" class=\"vfb-control-label\">What is your concern?  <span class=\"vfb-required-asterisk\">*<\/span><\/label><div><textarea id=\"vfb-field-975\" class=\"vfb-form-control\" placeholder=\"\" required=\"required\" rows=\"10\" name=\"vfb-field-975\" cols=\"50\"><\/textarea><\/div><\/div><\/div><div class=\"vfb-clearfix\"><\/div><div class=\"vfb-col-12 vfb-fieldType-textarea\" id=\"vfbField976\"><div class=\"vfb-form-group\"><label for=\"vfb-field-976\" class=\"vfb-control-label\">Was there anyone else involved?<\/label><div><textarea id=\"vfb-field-976\" class=\"vfb-form-control\" placeholder=\"\" rows=\"3\" name=\"vfb-field-976\" cols=\"50\"><\/textarea><\/div><\/div><\/div><div class=\"vfb-clearfix\"><\/div><div class=\"vfb-col-6 vfb-fieldType-select\" id=\"vfbField977\"><label for=\"vfb-field-977\" class=\"vfb-control-label\">How often does this \/has this happened?<\/label><div><div class=\"vfb-form-group\"><select id=\"vfb-field-977\" class=\"vfb-form-control\" placeholder=\"\" name=\"vfb-field-977\"><option value=\"Once\">Once<\/option><option value=\"Every hour\">Every hour<\/option><option value=\"Every day\">Every day<\/option><option value=\"More than once per week\">More than once per week<\/option><option value=\"Every couple of weeks\">Every couple of weeks<\/option><option value=\"Every couple of months\">Every couple of months<\/option><option value=\"I don&rsquo;t know\">I don\u2019t know<\/option><option value=\"\" selected=\"selected\"><\/option><\/select><\/div><\/div><\/div><div class=\"vfb-col-6 vfb-fieldType-text\" id=\"vfbField978\"><div class=\"vfb-form-group\"><label for=\"vfb-field-978\" class=\"vfb-control-label\">Your name<\/label><div><input id=\"vfb-field-978\" class=\"vfb-form-control\" placeholder=\"\" type=\"text\" name=\"vfb-field-978\" value=\"\"><span class=\"vfb-help-block\"> Please provide your name here. Your name will not be disclosed, to the person about whom this concern is made, without your permission. Please note: providing your name helps us to follow up on your concern; this is not always possible if you do not provide your name.<\/span><\/div><\/div><\/div><div class=\"vfb-clearfix\"><\/div><div class=\"vfb-col-12 vfb-fieldType-checkbox\" id=\"vfbField979\"><label for=\"vfb-field-979\" class=\"vfb-control-label\"> <span class=\"vfb-required-asterisk\">*<\/span><\/label><div><div class=\"vfb-checkbox\"><label><input id=\"vfb-field-979-0\" class=\"\" placeholder=\"\" data-vfb-multiple=\"vfb-field-979\" required=\"required\" type=\"checkbox\" name=\"vfb-field-979[0]\" value=\"1\">I understand that this notification may not be read immediately if I am sending it outside of school hours. You must check this box before sending a notification.<\/label><\/div><\/div><\/div><div class=\"vfb-clearfix\"><\/div><div class=\"vfb-col-12 vfb-fieldType-submit\" id=\"vfbField980\"><button id=\"vfb-field-980\" class=\" btn btn-primary\" placeholder=\"\" type=\"submit\" name=\"_vfb-submit\">Submit<\/button><\/div><div class=\"vfb-clearfix\"><\/div><\/form>\n","protected":false},"excerpt":{"rendered":"","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"_links":{"self":[{"href":"https:\/\/www.rossmoyneshs.wa.edu.au\/forms\/index.php?rest_route=\/wp\/v2\/pages\/4790"}],"collection":[{"href":"https:\/\/www.rossmoyneshs.wa.edu.au\/forms\/index.php?rest_route=\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/www.rossmoyneshs.wa.edu.au\/forms\/index.php?rest_route=\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/www.rossmoyneshs.wa.edu.au\/forms\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.rossmoyneshs.wa.edu.au\/forms\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=4790"}],"version-history":[{"count":4,"href":"https:\/\/www.rossmoyneshs.wa.edu.au\/forms\/index.php?rest_route=\/wp\/v2\/pages\/4790\/revisions"}],"predecessor-version":[{"id":18010,"href":"https:\/\/www.rossmoyneshs.wa.edu.au\/forms\/index.php?rest_route=\/wp\/v2\/pages\/4790\/revisions\/18010"}],"wp:attachment":[{"href":"https:\/\/www.rossmoyneshs.wa.edu.au\/forms\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=4790"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}