Bullying & Other Forms of Aggressive Behavior Complaint Form
If you have any issues or questions regarding this form, please contact your Parent Liaison, Mr. Alex Jones, at 419.984.1115 or by email at ajones@scs-k12.net.
Child Complainant: *
Home Address: *
Home Phone: *
Cell Phone: *
Date(s) of alleged incident(s): *
Location(s) and time(s) of alleged incident(s): *
Witness name(s), if any, to alleged incident(s): *
Describe the incident(s), as clearly as possible, including verbal statements and/or if physical contact was involved: *
Please upload any witness statements or any other supporting evidence. *
Required
Did this student request this complaint to remain anonymous? *
Required
If the answer 'Yes' was selected above, does the student understand the limitations of such reporting?
Please list your name and contact phone number: *
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