CCS Bullying and Harassment Report
Bullying and harassment are serious and will not be tolerated. This form allows you to report bullying or harassment that you personally witnessed occurring on school property, at a school-sponsored activity or event, on a school bus, or on the way to or from school, in the current school year. Sending in a false report makes it harder for your school to help the people who really need it.

If you fear that someone is in immediate danger, call 911.

Your report will be emailed to the school Administrator.

This form was developed from the Sauk Prairie School District Bullying / Harassment Reporting form.

Your first and last name (optional).
Your answer
Name of person being bullied or harassed (first and last name).
Your answer
Name of person doing the bullying or harassment (first and last name).
Your answer
Where did the incident occur?
Your answer
When did the incident occur (time and date)?
Your answer
Describe what you witnessed in detail and in chronological order.
Your answer
Who else witnessed the incident?
Your answer
Have you spoken to anyone about the incident, and if so, who?
Your answer
Submit
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