GMS Peer Conflict Report
Student Making Complaint
Name of Person(s) you believe harassed you:
List any witnesses that were present:
Where did the incident occur? (Be specific. "In school" doesn't help. Say the teacher's classroom, or the specific spot in the hallway, etc.)
When did the incident occur? (Be specific)
Describe the incident as detailed as possible.
Exact statements of what was said, any physical contact, anything that lead to the incident, etc.
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