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Form number: 236-4
Audience: MCPS Staff, School Staff, Principals
Last revised: July 2020
INSTRUCTIONS: This form should be completed electronically (NOT handwritten) by a school administrator and/or the security team leader/ designated security staff member. As required in MCPS Regulation COB-RA, Incident Reporting, the arrest also must be reported to the Office of School Support and Improvement (OSSI) by phone call within one hour, even if all facts about the arrest have not been assembled, so that the arrest can be recorded in the Incident Management System. The arrest may necessitate additional reporting to law enforcement or other external agencies on a case-by-case basis. See MCPS Regulation COB-RA, Incident Reporting, for additional guidance.
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