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ADMIN ACTION FOR HARASSMENT, INTIMIDATION, AND BULLYING
Post Action Report for Admin Team 
 
Questions with * are required before submitting.  

Date and time report was received:*
Date and time 1st action was taken:*
Names of who took action:*
Subject:*
Choose Location:*


Incident Date:
Date the matter was considered closed:
Did a physical injury result from the incident?
Was the target absent from school as a result of the incident?
Name of school adult you've already contacted (if any):
Describe any physical injuries:
How did you learn about the bullying?
Targeted Student:
Name of Bullie(s):
Why do you think the harassment, intimidation or bullying occurred?
What Happened?









Where did the incident happen?
Optional Name:
Summary:*
Witnesses:
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To validate your submission, please type the answer to the question.

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