Harassment, Intimidation, and Bullying Report
Your Name: (Optional)
Select the school:
Eastern Pulaski Elementary School
Winamac Community Middle School
Winamac Community High School
Who was the victim?
Who was harassing, intimidating, bullying, or causing harm?
Were there any witnesses?
Date of incident:
Time of incident:
Cause of harassment, intimidation, bullying, or harm:
Method of harassment, intimidation, bullying, or harm:
Describe what happened:
Is this the first time this victim has been bullied by this person?
I declare that this report is true to the best of my knowledge and belief, and that I understand that the contents will be used to assist students in need.
By clicking this box I agree to the above disclaimer
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This form was created inside of Eastern Pulaski Community Schools.