Bath Local Schools
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Elementary Brick Paver
Elementary Bully Report
This form is used to report bullying at Bath Elementary School.
Your Name (optional)
Date of Incident
Time of Incident?
Where did this incident take place?
Name of bully(ies)?
Name of victim(s)?
Name of bystander(s)?
Type of bullying (ex. physical, emotional, etc.)?
Description of incident?
To validate your submission, please type the answer to the following question:
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