Bullying, Harassment or Intimidation Report Form
Anti-Bullying/Anti-Harassment Policy: Students

It is the policy of Edgewood College to maintain an educational environment free from bullying, harassment or intimidation.  

We are committed to providing our students with a safe school environment where all members of the school community are treated with dignity and respect.

To this end, Edgewood College has in place robust policies, procedures, and practices, with consequences designed to reduce and eliminate bullying and harassment.

Please, be rest assured we will investigate incidents of bullying or harassment immediately.

We thank you for your usual support and cooperation.
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Name of student bullied/harassed:
Do not fill this if you choose to keep your identity anonymous
Grade *
Date(s) and time the bullying incident took place: *
MM
/
DD
/
YYYY
Time
:
Names of student(s) who bullied or harassed you:
Where did the incident happen? Check all that apply: *
Required
Describe in detail exactly what happened *
Describe any physical evidence that exists and is related to the incident. You may include physical marks, email(s) , websites(chats) , video/audio tapes, photos or other evidence. *
Name(s) of Witnesses: *
Who did you tell at school? *
I AGREE THAT ALL OF THE INFORMATION ON THIS FORM IS ACCURATE AND TRUE TO THE BEST OF MY KNOWLEDGE: *
E-mail address
Do not fill this if you choose to keep your identity anonymous
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