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POLLARD SCHOOL BULLYING AND HARASSMENT INCIDENT REPORTING FORM
(NOTE: Reports may be made anonymously, but no disciplinary action will be taken against an alleged aggressor solely on the basis of an anonymous report.)
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Name of Reporter:
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Check whether you are the:
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Target of the behavior
Reporter (not the target)
Check whether you are a:
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Student
Parent
Staff Member
Administrator
Other:
Date of this report
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