St. Lawrence Elementary School Complaint Form
The purpose of this form is to inform the district of an incident or series of incidents of bullying and/or harassment so we can investigate and take appropriate steps. If you feel unsafe, if your child/student feels that way, or if you are a witness to bullying, please fill out this form.
Please also refer to the district website DASA page for more information on bullying.

We also urge you to speak directly with the building principal by calling the main office of the appropriate school as soon as possible so we can address your concerns. Any supporting documentation should also be delivered to the building principal.

When filling out this form the respondent is doing so with the understanding that the examination and corresponding response and/or addressing of the complaint will take place during regular business hours on Monday-Friday when school is in session. If you feel that you as a student or your child is in immediate danger from harassment or bullying we encourage you to call your local police for assistance.

Please also refer to the district website DASA page for more information on bullying.
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Your name and contact information - *this report can be completed anonymously, but doing so may limit the follow up that may occur. If you wish to remain anonymous, please write "anonymous" below. 
Victim's Name *
Describe the incidents. Please include when and where it happened, including dates and specific locations along with your description. *
List the name(s) of the individual(s) accused of bullying and/or harassment *
Please list the names of any witnesses.
I certify that all statements on this form are accurate and true to the best of my knowledge.   *
Required
Note on Confidentiality: In order to investigate the complaint, the district will disclose the content of the complaint only to those persons who have a need to know. This form will not be shown to the accused student(s)/staff.  As such incidents are confidential, results of any investigation can not be shared. 
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