Winthrop Public Schools Anonymous Bullying Complaint Report Form
Students, parents and any member of the Winthrop community can anonymously report bullying by completing the complaint form below. Reports will be forwarded via email directly to the appropriate building principal for investigation. Reports may be made anonymously; however, adding more information to the report will aid the principal in dealing with the report more effectively. Room has been provided on this reporting form for the reporter to include his or her name and contact information. The Winthrop Public Schools will fully investigate all reports, anonymous or otherwise, and will notify parents of both the target and the aggressor, as required by law. However, no disciplinary action will be taken against an alleged aggressor solely on the basis of an anonymous report.
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School Information
School *
Grade
Reporter Information
Name of Reporter (not required, but helpful)
Indicate whether you are a:
Clear selection
Are you:
Clear selection
Phone number (not required, but helpful)
Incident Information
This may include but is not limited to incidents of discriminatory and sexual
harassment, retaliation, sexual misconduct/assault and bullying.
Name of target
Target is a
Clear selection
Name of aggressor
Aggressor is a
Clear selection
Date(s) of incident
Time of incident(s)
Location of incident(s)
Witnesses
 (anyone who saw the incident or has relevant information)
Witness names
Witnesses are
Clear selection
Description of incident
Please describe in detail the incidents of alleged misconduct; including where and when the incidents occurred. Please name any witnesses that may have information regarding the alleged misconduct.
Description of past incidents
Please describe any past incidents that may be related to this complaint.
I certify that the information provided in this report is true, correct and complete to the best of my knowledge.
Submit
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