Bullying Report
Emmons School maintains a policy prohibiting all forms of bullying. This form is sent to appropriate school personnel, who will investigate the report, and respond as necessary. Any student who knowingly makes a false accusation of bullying shall be subject to disciplinary action.
Your Name (First & Last) *
Your answer
I am a *
People involved in incident *
You must include the name of the victim and bully/bullies.
Your answer
Describe what happened *
Include information on the bully, victim, any witnesses/bystanders; the more detail you provide the better.
Your answer
Location the bullying occured *
Date and time of incident *
MM
/
DD
/
YYYY
Time
:
How would you like us to follow up on this? *
If you answered "other" to the previous question, please explain:
Your answer
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