Jonesville Elem/Middle

Online Bullying Report Form - JEMS
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Kathy Taylor, Principal

Online Bullying Report Form JEMS

Please answer the following questions.

1.)  At what school did the incident occur?    

2.) Name of student   

3.)  Grade of student  

4.) Name(s) of alleged perpetrators.  

5.) Description of incident including approximate date(s).



6.) Name(s) of individual(s) who may have information or been a witness to the incident. 

7.) Have other similar incidents occurred?  If so, when?

8.) Were the other incidents reported?  If so, when?

9.) Name, email and phone number of complainant.

  



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