Inadvertent Website Access

REPORT FORM FOR INADVERTENT WEBSITE ACCESS

Name:
Building:
User is: Employee Student

Date of Request (mm/dd/yyyy)
I inadvertently accessed the following inappropriate website(s) while conducting legitimate educational research or district business.
Website address(es):

Brief, general description of inappropriate content (i.e., drug paraphernalia, sexual content, ect.):

*Please submit this form to a classroom teacher or building administrator

*************************************************************************************************************************************** For District Use Only** Please submit completed forms directly to the Director of Technology or designee Website has been reviewed and Internet blocking/filtering adjusted as necessary Yes: No: Rationale: Signature of Director of Technology or designee: Date of approval:

Security Measure

Claysburg-Kimmel School District