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:
Alcohol / Drug Abuse
Connection to incident:
What is your relation to what happened.
Friend of Victim
Friend of Suspect
How did you learn of this issue?
Involved (need help here)
Internet (Facebook, blog, website...)
Victim Told Me
Persons Involved in Incident
Please list the Person(s) involved, if known, and their relation to the incident.
Date and Time of the incident.
Location where the incident took place:
Describe the incident, request an action or request a change to current procedures.
If you would like to be contacted further about this issue please provide your name and phone number or email.
Never submit passwords through Google Forms.
This form was created inside of Willamina School District.