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Public Story Entry: Adult victims of school corporal punishment



UrStory using Participant’s Name
(If this story is about someone else, please refer to them by using an alias name.)

Note: Fields marks with * are required

Your Information:
* First Name:
May we contact you by phone?
* Last Name:
May we contact you by email?
* Gender:
May we publish your story wherever we believe it will receive maximum support?
* Ethnicity:
Are you willing to be interviewed by the media? (You can remain anonomous)
* Email:
Phone:
Corporal Punishment Incident Data:
Name of School:
* Where did the paddling take place?
School District:
* Who paddled you?
* U S State:
* Name of the paddler:
Territory:
* Did the paddler place their hands on your body or touch any part of your clothing prior to the paddling?
* How old where you at the time of the paddling?
If yes, where were you touched?
* What grade where you in at the time of the paddling?
* How many times were you struck with the paddle?
* About how much time went by between your learning that you would be paddled and the time the paddling took place?
For what reason where you paddled?

* What was told to you by the paddler afterwards?

* What was told to you by the paddler beforehand?

How many times where you paddled in school?
1. School Year : -
no. times

3. School Year : -
no. times

2. School Year : -
no. times
4. School Year : -
no. times
Witnesses and Parental Consent:
* Had your parents/guardians submitted a signed note permitting the school to paddle you?
* Was there a witness present during the paddling?
* Were your parents/guardians warned prior to the paddling?
If yes, who was the witness?
* If your parents/guardians did not submit a note permitting the paddling, what was their response to it once it took place?
Name of the witness (indicate Ms. Mr.):
You can upload images or files
Did the witness strike you also?
* Have you told others about the paddling?
* In what way were those who you told about the paddling helpful or not helpful at all?
Tell us UrStory:
Please tell us your story (200 words or less)
 
 



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