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S.E. Gross Bullying Report

If you have a social emotional or behavior concern that involves a student/child, please contact the building administrator/s immediately. Incidents that involve the definition of bullying (see Illinois School Code below), please complete the following form.

ILCS 5/27-23.7: The definition of bullying includes cyberbullying and means any severe or pervasive physical or verbal act or conduct, including communications made in writing or electronically, directed toward a student or students that has or can be reasonably predicted to have the effect of one or more of the following:

  • Placing the student or students in reasonable fear of harm to the student’s or students’ person or property;
  • Causing a substantial detrimental effect on the student’s or students’ physical or mental health; 
  • Substantially interfering with the student’s or students’ academic performance; or
  • Substantially interfering with the student’s or students’ ability to participate in or benefit from the services, activities, or privileges provided by the school.

Please complete the form below. Required fields marked with an asterisk *

Your Information (Optional)

Your Role*
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Incident Information

School*
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Location*
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Cause of harassment, intimidation, bullying or harm*
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Method of harassment, intimidation, bullying or harm*
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What is the victim's role?*
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What was the offender's rold?
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