NIMS User Request Form

1. How many NIMS users will your school have? *

1
2
3

2. Name of School (Location): *

3. Are you aware of any sensitive incidents within your school at this time?
(Examples of a sensitive incident include staff bullying and harassment, incidents of a sexual nature, etc.) *

Yes
No

4. Principal Details: *

Name:	*
Date:	*
Phone number:	*

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