subject_line
What are you reporting?
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Abuse at Home (or elsewhere)
Bullying (face to face, telecommunication, social media)
Concerns about a fellow student (self-harm, suicidal ideation, etc.)
Criminal activity (drugs, extortion, theft, vandalism, rape, etc.)
Fights
General threats to campus safety or the campus environment
Which school does the situation concern?
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Carlisle High School
Chamberlain Middle School
Grigsby Intermediate School
Alden Brown Intermediate School
Do you want to be contacted?
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Yes
No
Name of Person Reporting Bullying/Emergency * Not Required
Phone Number of Person Reporting Incident * Not Required
Email Address * Not Required
First and Last Name of person being Bullied/Victim ***Must have a name or it cannot be dealt with
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First and Last Name of Person Making Threats/Bullying/ETC
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Description of incident
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NO ISSUE IS TOO SMALL
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🛈
When did the incident occur? (Specific dates and times should be identified when and where possible.)
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Where did the incident occurs? (Specific locations should be identified when and where possible. e.g. - "At Carlisle High School in the commons by the trophy case.")
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Is there any evidence or witnesses?
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Yes
No
Type of evidence and/or names of witnesses:
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Do you want to be contacted immediately or once the investigation is complete? ** We cannot share details of investigation due to Ohio Law, but inform you that it has been dealt with.
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I do not need to be contacted
Immediately
Once the investigation is complete
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