LaCrosse Bullying Report Form
Bullying is hurtful and is not tolerated at Tri-Township Consolidated School Corporation. It can be hard to tell an adult about bullying. Some kids worry that they will be called a “tattletale” or “snitch.” Reporting bullying to adults and the school is important because we can help put a stop to it. If you or another student has been bullied or hurt, or you are worried that you or another student could be bullied or hurt in the future, tell a teacher, counselor, principal, or another staff member at our school. We want to help.

"Bullying"(per IC 20-33-8-.2)means overt, unwanted, repeated acts or gestures, including verbal or written communications or images transmitted in any manner(including digitally or electronically), physical acts committed, aggression, or any other behaviors, that are committed by a student or group of students against another student with the intent to harass, ridicule, humiliate, intimidate, or harm the other targeted student and create for the targeted student an objectively hostile school environment that:
(1) places the targeted student in reasonable fear of harm to the targeted student's person or property;
(2) has a substantially detrimental effect on the targeted student's physical or mental health;
(3) has the effect of substantially interfering with the targeted student's academic performance; or
(4) has the effect of substantially interfering with the targeted student's ability to participate in or benefit from the services, activities, and privileges provided by the school.

You can fill out this form to tell staff about bullying that has happened this school year. Please let us know immediately when you are bullied so we can take action quickly.
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Date: *
Student who was harmed: *
Student(s) who did harm: *
When and where did the bullying take place? *
Did the bullying include mean comments about you or your friends? *
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