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 -, Middle School -, High School - (Reports will go to the building principal and superintendent.)
Email address *
Name of complainant: *
Role of complainant (i.e. Parent, Student, etc): *
Name of student being harassed or bullied: *
Name of alleged harasser or bully: *
Date of Incident: *
Location of incident or incidents: *
Building harassed student attends: *
Description of misconduct: *
Name of witnesses (if any):
Any other information:
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. *
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