Bullying Report

Harassment or bullying are serious and will not be tolerated by the Greater Nanticoke Area School District. This is a form to report alleged harassment or bullying that occurred on school property; at a school-sponsored activity or event off school property; on a school bus; or on the way to and/or from school, in the current school year. If you are a student victim or friend of a student who is being harassed or bullied and wish to report an incident of alleged harassment or bullying, complete this form. The information will be sent to the Assistant Principal, Mr. Gorham.
The information provided in this form is confidential and can be submitted anonymously.

Todays Date:

Student Reporting the Incident (optional):

Was an adult near at the time? If so, who?:

Details of the incident:

Name of the student it happened to:

The date it happened:

The time it happened:

Where did it happen?

Were there any witnesses? If so, who?

Name(s) of the student(s) allegedly causing the problem:

Details of the situation: