Student Bullying Report Form

Your Information

How were you involved in the incident?

Incident Details

When did the incident happen?

Where did the incident take place?

If there were any witnesses, please provide their names here.

Please explain what happened.

Who else have you reported this incident to?

From time to time, the district experiences phone line issues. If you should run into a problem calling in, parents may still contact the Elementary and High School Offices at the following numbers: Elementary School - (570) 853-3092 or High School - (570) 853-3918.