Report a Bully Form
Please provide the most information so that the School District Administrators can follow up to resolve this reported issue.
Who are you?
Where did this occur?
Ladysmith Middle and High School
FORMER Middle School
Location of incident?
Outside on School Property
Indoor Athletic Facilities
Date of incident?
Approximate time of incident:
Approximate number of times this has occurred?
This was the first time.
One other time.
Once a week.
Once a month.
Have you reported this to an adult at school?
Have you reported this to an adult outside of school?
Who was bullying, harassing, intimidating or causing harm? (Name and grade)
Describe what happened. (Please provide as much detail as possible)
If you are not a student at this campus and would like someone to contact you, please leave your phone number.
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