YME Bullying Report Form
Reporting bullying or harassing behavior helps make our school a safe and an inviting place to learn. Please report any bullying incidents involving our students using this form. Clicking submit will directly notify school administration and other school staff (ie - school social worker, etc.). We will do our best to ensure that names remain confidential. Please follow up if you do not hear from us in a timely fashion. Thank you for your help in making YME school the best we can be.
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Email *
Victim Name (First and Last) *
May we use your name during our investigation? *
Name of reporter if other than victim *
Victim's Grade Level *
Describe the incident, in as much detail as possible. What happened? (provide evidence of bullying ie: are there letters, photos, texts, social media posts, etc.) when available. Please keep track of all physical evidence. *
Date and time of incident: *
Example: 01/05/2019 at 2:00 p.m.
Location of Incident: *
Example: Hallway, bus, classroom, internet, lunchroom
Name(s) of the alleged bully (bullies) and grade levels. *
List any other witness(es): *
Which of the potential bullying situations best describes the incident? Check all that apply. *
Was the incident reported to anyone else? If so, to whom and when? *
Is there anything you may have said or done that the other party or parties may consider is also bullying or have been misunderstood? If yes, please list and explain. *
A school official will begin working on this issue. Please feel free to contact us personally (320-564-4081) if you have further questions or concerns. Thank you. BRE Principal Lisa Hansen, YME MS/HS Principal Brennan Kent *
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