Sims Middle

Online Bullying Report Form - Sims Middle School
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Dr. Latunya Means, Principal

Online Bullying Report Form SIMS

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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