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.)
* Required
Email address
*
Your email
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:
*
Choose
Elementary School
Middle School
High School
Alternative School
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
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