Request edit access
Bullying: Anonymous Report of Incidents at Lyman Memorial High School
Lebanon Public Schools and Lyman Memorial High School continually strive to provide students and staff with a positive educational environment void of bullying and other destructive behaviors. Unfortunately, we realize that various forms of bullying have the potential of taking place both inside and outside the school environment.

"Bullying" means (A) the REPEATED use by one or more students of a Written, Oral or Electronic Communication, such as Cyber Bullying directed at or referring to another student attending school in the same school district, or (B) a Physical act or Gesture by one or more students repeatedly directed at another student attending school in the same school district, that: (i) Causes physical or emotional harm to such student or damage to such student's property, (ii) places such student in reasonable fear of harm to himself or herself, or of damage to his or her property, (iii) creates a hostile environment at school for such student, (iv) infringes on the rights of such student at school, or (v) substantially disrupts the education process or the orderly operation of a school. Bullying shall include, but not be limited to, a written, oral or electronic communication or physical act or gesture based on any actual or perceived differentiating characteristic, such as race, color, religion, ancestry, national origin, gender, sexual orientation, gender identity or expression, socioeconomic status, academic status, physical appearance, or mental, physical, developmental or sensory disability, or by association with an individual or group who has or is perceived to have one or more of such characteristics.

This form provides an anonymous way to communicate bullying to school administration, who can use any information provided to investigate the claims.

Please view the following link to the Lebanon Board of Education Bullying Policy.

http://www.lebanonct.org/joomla/images/PDFs/District/BOEPolicies/5131%20911%20revised.pdf


When did the events occur? (Approximate date) *
MM
/
DD
/
YYYY
At what time did the events occur? *
Your answer
Where did the events occur? *
Your answer
Who was involved? *
Your answer
Describe the events in as much detail as possible. *
Your answer
Submit
Never submit passwords through Google Forms.
This form was created inside of Lebanon Public Schools. Report Abuse - Terms of Service