Report Bullying
Please correct the following errors.
Name of Reporter/Person Filing the Report:
(Note: Reports may be made anonymously, but no disciplinary action will be taken against an alleged aggressor solely on the basis of an anonymous report.)
Select whether you are the:
Target of the behavior
Reporter (not the target)
Check whether you are a:
Student
Staff member
Parent
Administrator
Other (Please specify)
Your contact information /telephone number:
If student, select your school:
J.C. Solmonese Elementary School
L.G. Nourse Elementary School
Henri A. Yelle Elementary School
Norton Middle School
Norton High School
If student, select your grade:
Kindergarten
1st grade
2nd grade
3rd grade
4th grade
5th grade
6th grade
7th grade
8th grade
9th grade
10th grade
11th grade
12th grade
If staff member, select your school or work site:
J.C. Solmonese Elementary School
L.G. Nourse Elementary School
Henri A. Yelle Elementary School
Norton Middle School
Norton High School
Information about the Incident
Name of Target (of behavior):
Name of Aggressor (Person who engaged in the behavior):
Date(s) of Incident(s):
Time When Incident(s) Occurred:
Location of Incident(s) (Be as specific as possible):
Witnesses (List people who saw the incident or have information about it):
Witness 1
Name
Check whether they are:
Student
Staff
Other (Please specify)
Witness 2
Name
Check whether they are:
Student
Staff
Other (Please specify)
Witness 3
Name
Check whether they are:
Student
Staff
Other (Please specify)
Describe the details of the incident (including names of people involved, what occurred, and what each person did and said , including specific words used).
What would you like to submit?
Question
Comment
Suggestion
Concern
Compliment
Tell us who you are
(Select one or more)
Norton Public Schools Student
Norton Public Schools Parent/Guardian
Norton Public Schools Employee
Community Member
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