Bullying/Harassment Form
If you have witnessed or have been a victim of bullying or harassment, please fill out this form to share with Platteville School District staff.
Sign in to Google to save your progress. Learn more
Email *
What is your name? *
Date of when the incident happened. *
Location of the incident. *
Name of the victim. *
If possible, click the school victim attends.
Clear selection
Name of the others who were allegedly involved. *
Names of any witnesses to the incident. *
Please explain what happened.
List evidence, if any: (IE:  letters/notes, graffiti, photos, e-mails, web sites, video/audio recordings, text messages, Facebook pages, etc.).
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Platteville School District.

Does this form look suspicious? Report