Elementary Bullying Questionnaire | Caledonia Area Public Schools ISD 299

First Name

Last Name

Phone

Date incident occurred

Who was being bullied?

What is the name of the bully?

Where did the incident occur?

Please describe the incident in as much detail as you can.

Please list any witnesses present.

Did you tell anyone about this?

Yes No

If you answered yes, who did you tell?

Caledonia Area Schools

Elementary Office:
511 West Main Street, Caledonia, MN 55921
Phone: (507) 725-5205
Fax: (507) 725-3558

Middle/High School Office:
825 North Warrior Avenue, Caledonia, MN 55921
Phone: (507) 725-3316
Fax: (507) 725-3319

District Office:
511 West Main Street, Caledonia, MN 55921
Phone: (507) 725-3389

Community Ed Office:
825 North Warrior Avenue, Caledonia, MN 55921
Phone: (507) 725-5139
Fax: (507) 725-3319