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Stop Bullying
At the Phoenix Central School District we take bullying seriously. Please fill out the form below to report incidents of bullying
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* Indicates required question
What is your name and how can we contact you?
Your answer
I am reporting this as a
Choose
Student
Parent
Community member
Staff
Are you the person being bullied?
Yes
No
Clear selection
If you are not the person being bullied, have you witnessed someone else being bullied?
Your answer
Who is the person being bullied?
*
Your answer
What time of day is this happening?
Your answer
Where is the bullying happening?
*
Choose
Emerson J. Dillon Middle School
On the bus
Other (Please describe)
Describe what is happening in the best way that you can.
Your answer
If you are the person being bullied, what do you want to have happen?
Your answer
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