Report Bullying - Complaint Form

Report Bullying - Complaint Form

Bullying Reporting Form
Hancock Central School is committed to providing a safe environment to all members of our community. Despite our best intentions, incidents between students do occur at times. If you wish to report a disturbing incident between two or more students, complete this form below.  Parents of aggressors and targets will be contacted in cases of confirmed bullying.

For more information on The Dignity for All Students Act, visit NYSED.gov .

Date of Incident:
Time of Incident:
Where did the incident occur?
Name of student bullying, harassing, intimidating or causing harm? (Include grade if known):
Name of person being bullied, harassed , intimidated or being harmed?
Please describe, in as much detail as possible, what happened.
Do you know any of the witnesses involved? If so, please provide as much detail as possible about these people.
Your name (optional):
If you would like someone to contact you regarding this, please include your phone number or email address here (optional):

To validate your submission, please answer the following math problem:

captcha math problem
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