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Onalaska ISD


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Report Bullying Form

Report of Bullying

If you are being bullied or witness it please report it to the Superintendent of Schools using the form below.


"Bullying" means a single significant act or a pattern of acts by one or more students directed at another student that exploits an imbalance of power and involves engaging in written or verbal expression, expression through electronic means, or physical conduct that has the effect or will have the effect of physically harming a student, damaging a student s property, or placing a student in reasonable fear of harm to the student s person or of damage to the student s property; or is sufficiently severe, persistent, or  pervasive enough that the action or threat creates an intimidating, threatening, or abusive educational environment for a student; materially and substantially disrupts the educational process or the orderly operation of a classroom or school; or infringes on the rights of the victim at school; and includes cyber bullying.


"Cyber bullying" means bullying that is done through the use of any electronic communication device, including through the use of a cellular or other type of telephone, a computer, a camera, electronic mail, instant messaging, text messaging, a social media application, an Internet website, or any other Internet-based communication tool.

Please note that while all reports of bullying will be investigated, no disciplinary action will be taken against a student solely on the basis of an anonymous report. 

Sections marked * are REQUIRED

*Choose school 


*Name of student target (victim) 

*Date of incident you are reporting 

*Where did the incident happen? Choose all that apply.
      On school property during the school day
      On a school bus on the way to/from school
      On a school bus on the way to/from a school-sponsored activity
      At a school-sponsored activity/event on school property
      At a school-sponsored activity/event OFF school property
      At a bus stop
      Locker room
      Parking lot
      Cyber-bullying  cellphone
      Cyber-bullying computer
      Other place If other, please specify 


*Has the appropriate teacher/coach/bus driver been contacted?  Yes      No  

If yes, please provide the name(s) of who you have contacted 

*Did you report this to anyone else, such as police, parent, other teacher, sheriff, etc.?  Yes      No  

If yes, please provide the name(s) of who you have contacted 

*Name(s) or description if unknown of alleged bully(ies) 

*Please select the statement(s) that best describe what happened. Choose all that apply.
      Hitting, kicking, shoving, spitting, hair pulling, or throwing something
      Getting another person to hit or harm the student
      Teasing, name calling, making critical remarks, or threatening, in person or by other means
      Demeaning and make the victim of jokes
      Making rude and/or threatening gestures
      Excluding or rejecting the student
      Intimidating, extorting, or exploiting
      Spreading harmful rumors or gossip
      Sexual Harassment
      Other if other, please specify 

*What did the alleged bully(ies) say or do?


*Why did the harassment or intimidation occur?

*Were there any witnesses or bystanders?  Yes      No  

If yes, please provide their name/s 

*Did physical injury result from the incident?  Yes      No  

Was the target (victim) absent from school as a result of the incident? Yes      No  

Please provide any additional information

*Has the target (victim) experienced problems with this particular person before? Yes      No  

If yes, please provide details. 

*What action do you believe the school should take with regard to this incident?

*If this matter proceeds to a formal hearing, will you appear and testify as to your knowledge of the matter?  Yes      No  

Name of person(s) making this report (optional) 

E-mail (optional) 

Phone Number (optional) 


*required fields



At Onalaska Independent School District we take the issue of student safety very seriously. Using this site to knowingly file a false report may result in disciplinary and/or legal actions being taken