Bullying Report Form
If you have been the target of bullying or have witnessed bullying at Wellington-Napoleon R-IX School District, please complete this form. Reports of bullying will be followed-up by the school counselor, and principal if necessary.
Your name (optional)
Your answer
Person reporting the bullying behavior *
What school is your concern in? *
Name of student(s) targeted by bullying or harassment *
Your answer
Person(s) alleged to have committed the bullying or harrassment *
Your answer
Date(s) of bullying incidents *
Your answer
Summarize the incidents or occurrences of bullying as accurately as possible. *
Your answer
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