WCSC Bullying Reporting

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Email *

Name (Optional)

You are the: *

Target

Reporter

You are a: *

Student

Staff

Parent

Administrator

Anonymous, Confidential, or Non-Confidential *

Anonymous - Individuals may file a report without revealing their identity. No disciplinary action will be taken against an alleged aggressor based solely on an anonymous report. Possible responses to an anonymous report include enhanced monitoring of specific locations at certain times of day or increased monitoring of specific students or staff.

Confidential - Individuals may ask that their identities be kept secret from the accused and other students. Like anonymous reports, no disciplinary action will be taken against an alleged aggressor based solely on a confidential report.

Non-confidential - Complainants agreeing to make their complaint non-confidential will be informed that due process requirements may require that the district release all of the information that it has regarding the complaint to any individuals involved in the incident, but that even then, information will still be restricted to those with a need to know, both during and after the investigation. The district will, however, fully implement the anti-retaliation provision of this policy and procedure to protect complainants and witnesses.

Targeted person? *

Targeted Student's School? *

West Central Elementary School

West Central Middle School

West Central High School

Alleged Bullies? *

Witnesses? *

Dates? *

Where did the incident(s) happen? Choose all that apply. *

Classroom

Lunchroom

Hallway

Restroom

Playground

Locker Room

Athletic Field

Parking Lot

School Bus

Off School Property

Internet

Cell Phone

Other:

Required

Please check the box that describes the alleged bullying behavior. Check all that apply. *

Sharing inappropriate drawings/cartoons/photographs/images/notes

Cyber bullying (bullying by calling, texting, emailing, web posting, etc.)

Spreading harmful rumors or gossip.

Hitting, kicking, shoving, spitting, hair pulling or throwing something at the individual.

Making rude, threatening and/or critical gestures or remarks.

Making the individual fearful, demanding money or exploiting.

Putting the individual down and making the individual a target of jokes, teasing, or name calling.

Excluding or rejecting the individual—motivated by race, color, religion, ancestry, national origin, cultural, gender, socio-economic status, sexual orientation including gender expression or identity, mental or physical disability or other distinguishing characteristics.

Making unwelcomed sexual advances, requests for sexual favors, sexually motivated physical contact or other verbal or physical conduct of a sexual nature.

Other:

Required

Why do you think the bullying occured? *

Is there any additional information you would like to provide?

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