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WMS Complaint of Alleged Bullying or Harassment
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* Indicates required question
Complainant's Name
This form may be submitted anonymously; however, it can be more challenging to remediate a bullying/harassment situation without the ability to collect further information from the complainant.
Your answer
Date
*
MM
/
DD
/
YYYY
Mailing Address
Your answer
Email Address
Your answer
Telephone Number
Your answer
I wish to complain against(Please include Student Name and Grade if known)
*
Your answer
Date(s) of alleged bullying or harassment:
*
MM
/
DD
/
YYYY
Is the bullying or harassment happening to you or is this bullying or harassment that you witnessed happening to someone else?
*
Your answer
What happened to you that caused you to file this complaint? Where did it happen? Who witnessed the behavior?
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Your answer
What informal steps have been taking, if any, to stop the behavior?
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Your answer
Is there anyone who could provide more information regarding this complaint?
*
Choose
Yes
No
If yes, please share their name and grade
Your answer
What outcome would you like to see?
*
Your answer
I certify that this information is correct to the best of my knowledge. (Type your name as your electronic signature)
*
Your answer
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