Delphi Community Elementary School/ Camden Early Childhood Center Reporting FormĀ 
Delphi Community School Corporation maintains a firm policy prohibiting all forms of bullying. Everyone is to be treated with respect and dignity. Bullying by any student, teacher, administrator, or other school personnel which creates an intimidating environment will not be tolerated under any circumstances.

Please use this form to report issues relating to bullying, cyber-bullying, racism, or other forms of harassment.

This information is confidential and will be shared with others only for investigation and follow-up purposes.

Please understand that all these questions are optional. However, without providing necessary information, it may be difficult to pursue this report.

Please be aware of the differences between the following:Ā 

šŸ’¢ Mean Moment

A mean moment happens when someone says or does something unkind on purpose, but it only happens once.

Example: Someone says, ā€œYour shoes are ugly,ā€ to hurt your feelings one time.

It’s not okay, but it’s usually a one-time choice to be mean.

āš–ļø Conflict

A conflict is a disagreement or argument between people who don’t get along at that moment.

Example: Two friends both want the same swing and start yelling at each other.
Conflicts can happen by accident, and both people are upset — but no one is trying to have power over the other.

🚫 Bullying

Bullying is when someone keeps being mean on purpose to another person again and again. It happens when one person has more power (like being older, stronger, or having more friends) and uses that power to hurt or scare someone else.

Example: A student keeps calling someone names every day and tells others not to play with them.

Bullying is not a one-time thing — it’s repeated, on purpose, and unfair.


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Your name (optional)
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Name of the person doing the bullying
Describe what happened.
Include information on the bully, the victim, any witnesses/bystanders.Ā  Please provide as much detail as possible.Ā 
Where did this happen?
When did this happen?Ā  (Date/Time)
Was it a Mean Moment, Conflict, or Bullying? *

šŸ’¢Ā Mean Moment

AĀ mean momentĀ happens when someone says or does something unkindĀ on purpose, but it only happensĀ once.

āš–ļøĀ Conflict

AĀ conflictĀ is aĀ disagreement or argumentĀ between people who don’t get along at that moment.

🚫 Bullying

BullyingĀ is when someoneĀ keeps being mean on purposeĀ to another personĀ again and again. It happens when one person has moreĀ powerĀ (like being older, stronger, or having more friends) and uses that power toĀ hurt or scareĀ someone else.Ā Bullying isĀ not a one-time thing — it’s repeated, on purpose, and unfair.


Required
Have you told anyone else about what happened?Ā  Who?
How can we help?Ā Ā 
Is there anything else we should know?Ā 
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