PS 054 Dr. George E. Blackman School of Excellence ECC

4) Names of the people involved and their role in the incident (witness or participant.) Include the person's grade and school, if known. Example response: John Doe-Participant-Grade 7-School 27 Required*

5) Space for additional name(s) (if needed): Required*

6) When did the incident take place? Required*

7) What happened? Describe the incident, giving as many details as possible: Required*

8) Have you told an adult about this incident? Required*

Yes

9) If you told an adult, who is the adult? (optional)

10) Your Name: (optional)

The following questions are optional. Answer only if you feel comfortable in sharing this information. All information will be held in the strictest confidence.

11) Grade of student victim (if known): (optional)

12) Phone number of person making this report: (optional)

13) School of the student victim (if known): (optional)

PS 054 Dr. George E. Blackman School of Excellence ECC
Forms

Forms

Report Bullying PS #054 DASA

1 forms were found.

Find Us

PS 054 Dr. George E. Blackman School of Excellence ECC2358 Main StreetBuffalo, NY 14214P: 716.816.3340F: 716.838.7403

School Hours

8:20 am - 3:15 pm
Principal
Dawne McNeal
Assistant Principal
Unseld Robinson
Grades
PK - 4