NEPN/NSBA Code: JIH-E
STUDENT SEARCH CHECKLIST
This checklist is to be completed for each individualized student search incident as soon as possible after the search.
Name/Title of Person Performing Search and Completing Form:
________________________________________________________________
Date: ______________________
1. Who was searched? ________________________________________________
2. Date, time and location of search _____________________________________
3. What factors caused you to have a reasonable suspicion that a search of this student or the student’s possessions would provide evidence that the student has violated or is violating the law, Board policies or school rules?
________________________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________
4. Was student’s consent requested? __________ Given? ___________________
[Consent is not required for search to be conducted]
5. What was searched (i.e., person, personal belongings, storage facilities)?
________________________________________________________________
________________________________________________________________
6. Who witnessed the search? ________________________________________________________________
________________________________________________________________
7. What did the search yield? __________________________________________
A. What evidence was seized? _______________________________________
B. Was receipt issued for seized items? _______________________________
8. Were police notified? _____________________________________________
9. Was any evidence released to police? Yes _____ No _____
If yes, what evidence? _____________________________________________
10. Were parents notified of the search, including the reasons and the scope?
Yes _____ No _____
A. If yes, how were they notified? ________________________________
B. If no, why not? _____________________________________________
11. Other relevant facts (if any)_________________________________________
_______________________________________________________________
_______________________________________________________________
_______________________________________________________________
Signature of Person Performing Search and Completing Form:
__________________________________________________
[NOTE: If search resulted in school disciplinary action and/or referral to law enforcement, this form should be retained in the student's file.
If search did not result in disciplinary action, this form should be retained in separate file in school or superintendent’s office.]
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