Newton County School District Bullying/Harassing Complaint Form

1. Name of person reporting: ______________________________________________
2. Specific nature of the misconduct: ________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
3. Date (s) of misconduct: ________________________________________________
4. Name (s) of victim(s) of the misconduct: ___________________________________
_____________________________________________________________________
5. Names of any witnesses of the misconduct: ________________________________
_____________________________________________________________________
6. Any information that may assist in the investigation of the complaint:

_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________

             Complaints should be submitted to a teacher, counselor, or principal.


Download Bullying Reporting Form and turn in to your principal.

Bullying Reporting Form