Incident Report

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Email Recipient(s) Please be sure to include Ministry Pastor, COD, Coordinator for approval *

First Name *

Last Name *

Email *

Incident Date *

Incident Time *

Who reported the incident? *

Contact Number *

Please provide the names and contact information for all parties involved in the incident *

Please describe the incident *

**Supporting Documentation**
Please email any supporting documentation to gnbcmarketing@gmail.com immediately following your form submission for Administrative review.