FORM B
ENFIELD PUBLIC SCHOOLS
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
Revised: March 27, 2012
Revised: May 12, 2015
28