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Cedar Hall Community School
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Harper Elementary School
Hebron Elementary School
Highland Elementary School
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Lodge Community School
McCutchanville School
Oak Hill School
Scott School
Stockwell Elementary School
Stringtown Elementary School
Tekoppel Elementary School
Vogel School
West Terrace Elementary School
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Academy for Innovative Studies Middle School
Helfrich Park STEM Academy
McGary Middle School
North Jr. High School
Perry Heights Middle School
Plaza Park International Prep Academy
Thompkins Middle School
Washington Middle School
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Academy for Innovative Studies High School
Benjamin Bosse High School
Central High School
F.J. Reitz High School
New Tech Institute High School
North High School
William Henry Harrison High School
District Wide
Academy of Science & Medicine
Culver Family Learning Center
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Randall T. Shepard Leadership & Law Academy
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(opens in new window/tab)
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Indiana Academic Standards
(opens in new window/tab)
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Bullying Form Report
Bullying Form Report
This form requires Javascript to be enabled for submission and authorization.
*
Required
Does what happened fit all three parts of bullying?
It is repeated?
There is an imbalance of power.
The person is being mean on purpose and wants to do harm.
Date
Must contain a date in MM/DD/YYYY format
Email Address
*
required
Time of Day
School
*
required
Caze
Cedar Hall
Cynthia Heights
Culver
Daniel Wertz
Delaware
Dexter
Evans
Fairlawn
Glenwood
Harper
Hebron
Highland
Lincoln
Lodge
McCutchanville
Oak Hill
Scott
Stockwell
Stringtown
Tekoppel
Vogel
West Terrace
Grade Level
Kindergarten
1st Grade
2nd Grade
3rd Grade
4th Grade
5th Grade
6th Grade
Teacher
Name of Targeted Student
What Happened?
What has happening before the problem?
When did it happen?
Where did it happen?
Bus
Playground
Hallway
Bathroom
Cafeteria
Classroom
Other
Other Location
Who was bullying?
Was an Adult told?
Yes
No
Not Sure
If yes, who was told?
What did the adult say the student should do?
Did the student do what the adult said?
Yes
No
If so, did it help?
Yes
No
Names of others who saw this happening
Submit