YME Bullying Report Form
Reporting bullying or harassing behavior helps make our school a safe and an inviting place to learn. Please report any bullying incidents involving our students using this form. Clicking submit will directly notify school administration and other school staff (ie - school social worker, etc.). We will do our best to ensure that names remain confidential. Please follow up if you do not hear from us in a timely fashion. Thank you for your help in making YME school the best we can be.
Victim Name (First and Last)
May we use your name during our investigation?
No - I wish to remain anonymous
Name of reporter if other than victim
Victim's Grade Level
Describe the incident, in as much detail as possible. What happened? (provide evidence of bullying ie: are there letters, photos, texts, social media posts, etc.) when available. Please keep track of all physical evidence.
Date and time of incident:
Example: 01/05/2019 at 2:00 p.m.
Location of Incident:
Example: Hallway, bus, classroom, internet, lunchroom
Name(s) of the alleged bully (bullies) and grade levels.
List any other witness(es):
Which of the potential bullying situations best describes the incident? Check all that apply.
Spreading False Rumors
Destruction of Property
Sexual, Religious, or Racial Harassment
Was the incident reported to anyone else? If so, to whom and when?
Is there anything you may have said or done that the other party or parties may consider is also bullying or have been misunderstood? If yes, please list and explain.
A school official will begin working on this issue. Please feel free to contact us personally (320-564-4081) if you have further questions or concerns. Thank you. BRE Principal Lisa Hansen, YME MS/HS Principal Ryan Luft
I plan to check in with school officials to follow up on my report.
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