Greene County CSD Anti-Bullying / Harassment Complaint Form
Please complete the bullying/harassment form below. If you have additional documentation you would like to submit, please email it to the building principal (Elementary - johnsons@greenecountycsd.net, Middle School - zanderss@greenecountycsd.net, High School - phillipsb@greenecountycsd.net). (Reports will go to the building principal and superintendent.)
Email address *
Name of complainant: *
Your answer
Role of complainant (i.e. Parent, Student, etc): *
Your answer
Name of student being harassed or bullied: *
Your answer
Name of alleged harasser or bully: *
Your answer
Date of Incident: *
MM
/
DD
/
YYYY
Location of incident or incidents: *
Your answer
Building harassed student attends: *
Description of misconduct: *
Your answer
Name of witnesses (if any):
Your answer
Any other information:
Your answer
I agree that all of the information on this form is accurate and true to the best of my knowledge. If you agree with this statement, type your name below. *
Your answer
Submit
Never submit passwords through Google Forms.
This form was created inside of Greene County CSD. Report Abuse - Terms of Service