Report Bullying & Harassment (SSCS DASA Reporting Form)
District DASA Coordinator - School Guidance Counselor: Ms. Lindsay Blowers, lblowers@sharonsprings.org
 
School Social Worker: Mr. Russ Scimeca, rscimeca@sharonsprings.org

Superintendent: Mr. Thomas Yorke, tyorke@sharonsprings.org

Deputy Superintendent, Patterson Green,  pgreen@sharonspring.org

For details about DASA: Visit www.sharonsprings.org > About Us > Dignity for All Students Act

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Your Name *
Your Phone Number and/or Email Address
Who is the "bully"? *
Who was "bullied"? *
What happened? PLEASE GIVE A DETAILED DESCRIPTION. *
Where did this happen? (Be as specific as possible so that we can look at video surveillance) *
What date did this happen?  (Be as specific as possible so that we can look at video surveillance)
MM
/
DD
/
YYYY
What time did this happen?  (Be as specific as possible so that we can look at video surveillance)
Time
:
Who saw this happen? *
Have you been threatened by anyone?
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