WNESU Student Conduct Reporting Form

Student Conduct Form

Staff, students, and families are encouraged to report all concerns that might constitute a violation of the District's policy on Hazing, Harassment, or Bullying (HHB) or Title IX Sexual Harassment through this form. All information will be routed to the appropriate Building Administrator / Designated Employee or WNESU Title IX Coordinator for timely follow up. Note: If you personally witnessed the conduct, you SHALL report conduct you reasonably believe MIGHT meet HHB criteria. If you did NOT personally witness the conduct, you SHALL report conduct that MIGHT meet HHB criteria.
Reporter Name:

First NameLast Name
Reporter's Email:
example@example.com
School:
Did you directly witness the incident you are reporting:
If you did not directly witness the incident please name witnesses here, if any known:
Identity of alleged student and / or staff offender(s) (if known):
Identity of complainant(s) (person or people targeted by the behavior):
Date and Time the alleged incident (if known):

MonthDayYear
Date
Hour MinutesAM/PM Option
Date report of harm shared with reporter:

MonthDayYear
Date
Time report of harm shared with reporter:

Hour Minutes

AM/PM Option
Please describe the witnessed or reported conduct of concern (or attach summary of concerns below):
Do you have any other information about the alleged conduct, separate from what you outlined above? If yes, please outline here:
Please describe any initial actions you have taken to address the alleged conduct (notified police and / or DCF, etc.):
New August 2020: Any alleged conduct that may constitute sexual harassment under Title IX must be reported to the District's Title IX Coordinator. If you believe the alleged conduct might violate the District's Title IX policy, please indicate that below to ensure a copy of your report is routed to the Title IX Coordinator's attention:
If you have any additional information (screenshots, statements, etc.) please upload and attach to this report:

Cancelof
Should be Empty:

Student Conduct Form