Salmon River Central High School Online Bullying Report
Salmon River Central School District is committed to providing a safe, supportive learning environment for all students. Bullying incidents can be reported directly to a trusted staff member, and/or DASA coordinator at your school. This online form may also be used by Salmon River students to report being bullied or by someone witnessing a student being bullied.

Once submitted, the investigation process will begin within five (5) working days. Keep in mind, this process can only be as thorough as the information provided.

Email address *
In which school/building did this incident occur? *
Where did the incident occur?
Name of person reporting the incident (optional):
Your answer
Phone number of person reporting the incident (optional):
Your answer
e-mail of person reporting the incident (optional):
Your answer
Select which best applies to you.
Please list names of alleged offenders:
Your answer
Please describe the bullying incident in as much detail as possible.
Your answer
Check all that apply.
How often has this occured?
Do you believe this incident was motivated by racism, homophobia, transphobia, disability, or a form of sexual harassment?
If you selected yes or maybe in the previous question, please provide an explanation for your answer.
Your answer
Verification
By completing this form, you are verifying that your statements are true and accurate to the best of your knowledge.

If you have trouble completing this form and would like to speak with someone, contact a trusted school staff member or the Assistant Superintendent for Curriculum and Instruction at (518) 358-6669.

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