Report possible incidents of Harassment, Intimidation or Bullying (HIB) using this form.
If you think an incident of HIB is occurring involving at least one Weehawken Township School District student, please complete this form.
Who is completing this form? *
What is your relationship to the school or any of the students involved? *
If we need additional information, how do you prefer we contact you? *
What is/are the name(s) of the alleged targeted student(s)? (the victims) *
What is/are the name(s) of the alleged perpetrators? (the student(s) committing the alleged acts of bullying) *
When did you witness or begin suspecting an alleged incident of HIB? *
MM
/
DD
/
YYYY
What time did you witness or begin suspecting an alleged incident of HIB? *
Time
:
Where did you witness or begin suspecting an alleged incident of HIB? *
Which school did you witness or begin suspecting an alleged incident of HIB? *
What specifically did you witness or why do you suspect there is an alleged incident of HIB? Be as specific as possible. *
Where there other witnesses? Please tell us who else we should contact.
Did you file a verbal report with the Principal on the same day of witnessing or receiving reliable information regarding behavior being reported?
Clear selection
Please write your name below to certify the information you provided in this form is accurate and true to the best of your knowledge.
Submit
Never submit passwords through Google Forms.
This form was created inside of Weehawken Board of Education. Report Abuse