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Bully Incident Reporting Form

Indiana's Bullying Legislation: IC 20-33-8-0.2 "Bullying" Sec. 0.2 As used in this chapter, "bullying" means overt, repeated acts or gestures, including (1) verbal or written communications transmitted; (2) physical acts committed; or (3) any other behaviors committed; by a student or group of students against another student with the intent to harass, ridicule, humiliate, intimidate, or harm the other student.

Bullying Incident Report Form
Please complete the bullying incident report. This report is anonymous. If you have an immediate concern, please contact the school's administration.

(*) Required


Please select all that apply(*)




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Type the name of the student(s) that are bullying and the school they attend.(*)

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Where did the bullying take place?



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Name of the student being bullied(*)

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Which school does this student attend?



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Description of Events (Please be specific - use exact wording, names, place, time, etc..)(*)

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When did this happen?(*)

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The administrators will investigate the report and take appropriate actions to deal with the situation. Since much of what we do needs to remain confidential, you may not know of the steps we take to stop the bullying. If the bullying does not stop, we need to take additional steps. Please let us know if the bullying continues.


Please follow the security step below and click the 'Submit' button.







Mission Statement

The mission of the Northeastern Wayne School Corporation, a partnership of students, staff, families, and community, is to provide all students the opportunity to achieve academic excellence, to acquire significant lifeskills and to meet their unique needs through a challenging and diverse curriculum presented in a positive and nurturing learning environment.

Air Quality Information

Indoor Air Quality (IAQ) Coordinator

Mr. Steve Burge
(765) 847-2284 - Voice
(765) 847-2936 - Fax
sburge@nws.k12.in.us


Contact Us!

Northeastern Wayne SC
Mrs. Laura Blessing, Superintendent
314 West Main St.
P.O. Box 406
Fountain City, IN. 47341
lblessing@nws.k12.in.us
(765) 847-2821 - Voice
(765) 847-5355 - Fax

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