Report Bullying

New York's Dignity for All Students Act took effect July 1, 2012.

For more information on DASA, visit the state's website by clicking HERE.

For the full text of Binghamton District - Dignity for All Students Act, please click HERE.

**If you need to report an instance of bullying, please complete the form below**

 
 
Report Bullying Form at Jefferson

 
 
Report Bullying Form at Jefferson
*Indicate required fields
 
*Date of Incident 
 
What time did it happen?
 
*Where did the incident occur?
 
If outside school, where? 
 
Who was bullying, harassing, intimidating or causing harm? (Include first name, last name and grade if known)
Who was the person being being harmed, bullied, harassed or intimidated?
 
*Describe the incident. Give as much information as you can. Let us know if there were any witnesses
Have you told anyone?
Name(Optional)
If you would like someone to contact you, please add your phone number or email address here. (Optional)

 



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