District Reporting Form
Elmwood Park CUSD 401 is committed to providing all students and staff with a safe and civil environment in which all members of the school community are treated with dignity and respect. Please use this form to report bullying, harassment, or any suspicious behavior/activities you may witness. It is completely anonymous unless you choose to identify yourself.
Note* This form will be checked during school hours, not on weekends or holidays.
Building in or near which incident occurred
Early Childhood Center
John Mills Elementary School
Elmwood Elementary School
Elm Middle School
Elmwood Park HS
Outside of a District Building
Date of observed incident
Approximate time of incident
Check all that apply
Before school hours
During school hours
After school hours
Please describe the incident you witnessed. The more details you can provide, the better.
Name and Contact Information
We take safety seriously. If you wish to remain anonymous, leave this question blank. If you wish to help with the situation, please place your first and last name on the line along with a number at which we can reach you. If this is an emergency situation, please additionally report this situation to a parent or the police immediately.
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This form was created inside of Elmwood Park CUSD 401.