Number of children involved in conflict 

Age of first child             Gender of first child      Race of first child N/A American Indian or Alaska Native Asian Black or African American Native Hawaiin or Other Pacific Islander White multi-racial Some other race

Age of second child      Gender of second child     Race of second child  N/A American Indian or Alaska Native Asian Black or African American Native Hawaiin or Other Pacific Islander White Some other race

Age of third child            Gender of third child     Race of third child N/A American Indian or Alaska Native Asian Black or African American Native Hawaiin or Other Pacific Islander White Some other race

Age of fourth child       Gender of fourth child     Race of fourth child N/A American Indian or Alaska Native Asian Black or African American Native Hawaiin or Other Pacific Islander White Some other race

Age of fifth child            Gender of fifth child     Race of fifth child N/A American Indian or Alaska Native Asian Black or African American Native Hawaiin or Other Pacific Islander White Some other race

first child is hispanic?          no yes

second child is hispanic?      no yes

third child is hispanic?          no yes

fourth child is hispanic?        no yes

fifth child is hispanic?           no yes

What day did the conflict occur?     Monday Tuesday Wednesday Thursday Friday

What time of day did the conflict occur (use 24 hour time, with colon)?    

Where did the conflict occur? Classroom Playground Hallway Lunchroom Bus Home On the way to-from school  

Other locations   

What was the conflict about? control of materials social order(friendships) individual rights

Other 

Briefly describe the conflict
 

How was conflict resolved? no resolution physically (fight, taking by force, etc) verbally Teacher imposed solution

Describe how conflict was resolved

    Your Name