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Suggestions and Reporting Form (Bullying)
Suggestion and Reporting Form

Directions: Suggestions are welcomed by Stamford Central School District. Please select it as your "Report Type" choice on this form. However, Harassment or Bullying are serious and will not be tolerated. This is a form to also report alleged harassment or bullying that occurred on school property; at a school-sponsored activity or event off school property; on a school bus; or on the way to and/or from school, in the current school year. If you are a student victim or a friend of a student who is getting harassed or bullied and wish to report an incident of alleged harassment or bullying, complete this form.


Report Type
Name: (May be filled out as anonymous)
Date of Incident:
Time of Incident:
Location of Incident:
Please check the type of incident experienced:
Please describe the incident or make suggestion in the text box below.
Witnesses?

Who?
Was a teacher informed of incident?

Who?
By clicking here, I hereby certify that the information I have provided in this complaint is true, correct and complete, to the best of my knowledge and belief.

To validate your submission, please type the answer to the following question:

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Stamford Central School District
1 River Street, Stamford, NY 12167
Phone: 607-652-7301  |   Fax: 607-652-3446
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