ENFIELD PUBLIC SCHOOLS FORM B
INTERNAL INVESTIGATION NOTES FOR REPORTS OF BULLYING BEHAVIORS For Staff Use Only :
Has student reporter requested anonymity ? Y N
Does the school have parent / guardian consent to disclose that a complaint as to this student has been filed in connection with the investigation ? Y N
Administrative Investigation Notes ( use separate sheet if necessary ): _____________________________________________________________________________________________ _____________________________________________________________________________________________ _____________________________________________________________________________________________ _____________________________________________________________________________________________ _____________________________________________________________________________________________ _____________________________________________________________________________________________
Bullying Verified ? Yes ___ No ____
Remedial Action ( s ) Taken :______________________________________________________________________________________ _____________________________________________________________________________________________ _____________________________________________________________________________________________ _____________________________________________________________________________________________ _____________________________________________________________________________________________ _____________________________________________________________________________________________ _____________________________________________________________________________________________ _____________________________________________________________________________________________ _____________________________________________________________________________________________ _____________________________________________________________________________________________ _____________________________________________________________________________________________ _____________________________________________________________________________________________ _____________________________________________________________________________________________ _____________________________________________________________________________________________ ( Attach bullying complaint and witness statements . If bullying is verified , attach notification to parents of students involved , invitation to parent meetings , and records of parent meetings ).
Adopted : January 24 , 2012 Page 15 of 19