Willamina School District Anonymous Bullying and Harassment Form
Willamina School District encourages students, and staff members to report any discriminating, harassing, bullying, abusive, or unsafe behavior as soon as possible through this form, to a school district official, or when appropriate, to law enforcement.
Issue or incident being reported:
Connection to incident:
What is your relation to what happened.
How did you learn of this issue?
Persons Involved in Incident
Please list the Person(s) involved, if known, and their relation to the incident.
Your answer
Date and Time of the incident.
Your answer
Location where the incident took place:
Your answer
Additional Information:
Describe the incident, request an action or request a change to current procedures.
Your answer
Contact information:
If you would like to be contacted further about this issue please provide your name and phone number or email.
Your answer
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