Incident Report Form 2018-2019
If you have information regarding bullying/harassment and would like to report this information anonymously, please fill out the following form to the best of your knowledge and submit.
Target/Victim's Name (first AND last)
School/Building of Target/Victim
Blue Earth Area Elementary
Blue Earth Area Middle School
Blue Earth Area High School
Alleged Aggressor's School
Blue Earth Area Elementary (Grades K-5)
Blue Earth Area Middle School (Grades 6-7)
Blue Earth Area High School (Grades 8-12)
Share as many details of the incident as possible.
Provide copies ( ie. letters, photos, texts, posts, etc.) when available.
Date of the Incident
Where did the incident occur?
Be specific as possible (ie. on a bus, on the way to/from school, at a school-sponsored event).
Please describe the incident, in as much detail as possible, what happened?
Do you know any of the witnesses involved?
Give as many details as possible.
Which statement(s) best describes what happened (choose all that apply)?
Destruction of Property
Sexual, Religious, or Racial Harassment
Spreading False Rumors
If you prefer to remain anonymous, please state why.
Can we use your name in our investigation, if we need to?
Never submit passwords through Google Forms.
This form was created inside of Blue Earth Area Schools.
Terms of Service