Bullying/Harassment Reporting Form

Dear Reporting Student or Individual,

This report is confidential and will be read only by the administrators (Ms. Keith, Ms. Wheeler, Ms. Stevenson, Mr. Ballard, and Dr. Herrmann).

We encourage you to speak to an adult (teacher, instructional aide, coach, club advisor, counselor, ACS, secretary, administrator, etc.) on campus about your feelings and concerns regarding this situation, in addition to using this reporting form.

PLEASE COMPLETE THE QUESTIONS BELOW:

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