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Triad Local Schools7920 Brush Lake Road, North Lewisburg, Ohio, 43060

Board Office (937) 826-4961 Treasurer's Office (937) 826-4004 FAX (937) 826-3281

Dr. Craig M. MeredithSuperintendent

Connie CohnTreasurer

IDistrict School

Semi Annual Reporting FormActs of: Verified Acts of Harassment, Intimidation, and/or Bullying

** Please copy this page if needed **'-M-l-'d-dl-e-S-ch-o-o-l---I

Category Date Date Location ResolvedReported Verified

Verified Harassment --~

1/2,/,? ,/z,t'Z.Classroom -- D

~

Verified Intimidation -- D School Property --.0"Verified Bullying -- D Bus to School -- D

~orNoReport of Harassment -- D Bus home from School-- DReport of Intimidation -- D School Sponsored Event -- D

Report of Bullying -- DVerified Harassment -- D Classroom -cJJ'Verified Intimidation -- jif Z{2.,{,'Z 'Z/~ -,f,-z School Property -- D

Verified Bullying -- D Bus to School -- D~NoReport of Harassment -- D Bus home from School -- D

Report of Intimidation -- D School Sponsored Event -- DReport of Bullying -- D

Verified Harassment -- D Classroom -- DVerified Intimidation -- D ~,dJZ 'hIts'; rz.

School Property -- WVerified Bullying -- j;( Bus to School -- D

@rNoReport of Harassment -- D Bus home from School -- DReport of Intimidation -- D School Sponsored Event -- D

Report of Bullying -- DVerified Harassment -- D Classroom -- DVerified Intimidation -- D School Property --~

Verified Bullying --~ ~,4rz ~,S"lrz Bus to School -- D ~orNoReport of Harassment -- D Bus home from School -- DReport of Intimidation -- D School Sponsored Event -- D

Report of Bullying -- DVerified Harassment --~

3(fL({,Z '!.1,~L'2Classroom --J(Y

Verified Intimidation -- D School Property -- DVerified Bullying -- D Bus to School -- D

SorNoReport of Harassment -- D Bus home from School -- DReport of Intimidation -- D School Sponsored Event -- D

Report of Bullying -- D

IC "Triad Local Schools: Successful learning today... productive living tomorrow. " )

Triad Local Schools7920 Brush Lake Road, North Lewisburg, Ohio, 43060

Board Office (937) 826-4961 Treasurer's Office (937) 826-4004 FAX (937) 826-3281

Dr. Craig M. MeredithSuperintendent

Connie CohnTreasurer

Semi Annual Reporting FormActs of: Verified Acts of Harassment, Intimidation, and/or Bullying

** Please copy this page if needed **I-D-I-·s-tr-ic-t-S-c-h-o-o-l-----.I-M-id-d-I-e-S-c-h-oo-l-------,I

Category Date Date Location ResolvedReported Verified

Verified Harassment -- 0 Classroom -- 0Verified Intimidation -- 0

31/~(,Z. 3/t\l-z.SchooIProperty--~

Verified Bullying --;;:r Bus to School -- 0QrNo

Report of Harassment -- 0 Bus home from School -- 0Report of Intimidation -- 0 School Sponsored Event -- 0

Report of Bullying -- 0Verified Harassment --]I( Classroom --~Verified Intimidation -- 0

r.f/'''!7 ci2 '-I/IZSchool Property -- 0

Verified Bullying -- 0 Bus to School-- 0~orNoReport of Harassment -- 0 Bus home from School -- 0

Report of Intimidation -- 0 School Sponsored Event -- 0Report of Bullying -- 0

Verified Harassment --¥ Classroom-~~Verified Intimidation -- 0 School Property --

Verified Bullying -- 0 (.1/2 t)"!fZ 'f/2 s-Irz Bus to School -- 0 ~orNoReport of Harassment -- 0 Bus home from School -- 0Report of Intimidation -- 0 School Sponsored Event -- 0

Report of Bullying -- 0Verified Harassment -- 0 Classroom -- 0Verified Intimidation -- 0

'i(2,{f2

School Property -- 0Verified Bullying -- 0 Bus to School -- 0

Yes or~Report of Harassment -- A(( Bus home from School -~!Report of Intimidation -- 0 School Sponsored Event --

Report of Bullying -- 0Verified Harassment -- J? Classroom -- 0Verified Intimidation -- 0 sf3! rz 41frz

School Property -- 0Verified Bullying --~ Bus to School -- 0

@rNoReport of Harassment -- 0 Bus home from School -- 0School Sponsored Event --)?'vReport of Intimidation -- 0

Report of Bullying -- 0

IC nTriad Local Schools: Successful learning today... productive living tomorrow." )

Triad Local Schools7920 Brush Lake Road, North Lewisburg, Ohio, 43060

Board Office (937) 826-4961 Treasurer's Office (937) 826-4004 FAX (937) 826-3281

Dr. Craig M. MeredithSuperintendent

Connie CohnTreasurer

IDistrict School

Semi Annual Reporting FormActs of: Verified Acts of Harassment, Intimidation, and/or Bullying

** Please copy this page if needed **I-M-i-d-dl-e-S-ch-o-o-l---I

Category Date Date Location ResolvedReported Verified

Verified Harassment -- 0

S!"!f2Classroom -- 0

Verified Intimidation -- 0

S{'l/f2School Property -~!

I---

Verified Bullying --~ Bus to School --§rNOReport of Harassment -- 0 Bus home from School -- 0

Report of Intimidation -- 0 School Sponsored Event -- 0Report of Bullying -- 0

Verified Harassment -- 0OS 1,I,z Classroom -- 0

Verified Intimidation -- 0 SchooIProperty--~Verified Bullying -- 0 Bus to School -- 0 -Yes @o/

Report of Harassment -- 0 Bus home from School -- 0 -Report of Intimidation -- 0 School Sponsored Event -- 0Report of Bullying --~

Verified Harassment -- 0 Classroom -- 0Verified Intimidation -- 0 s{u/,z SchooIProperty--~

Verified Bullying -- 0 Bus to School -- 0Yes Ol@

Report of Harassment -- 0 Bus home from School -- 0Report of Intimidation -- 0 School Sponsored Event -- 0

Report of Bullying -- 'Q"Verified Harassment --~

S (17(,'Z. ~/l7ltzClassroom --.2f

Verified Intimidation - 0 School Property -- 0Verified Bullying -- 0 Bus to School -- 0 ~orNOReport of Harassment -- 0 Bus home from School -- 0

Report of Intimidation -- 0 School Sponsored Event -- 0Report of Bullying -- 0

Verified Harassment -- 0 Classroom -- 0Verified Intimidation -- 0 School Property -- g- '"

Verified Bullying -- 0

~/z~tz.Bus to School --

Yeso@Report of Harassment -- 0 Bus home from School-- 0Report of Intimidation -- 0 School Sponsored Event -- 0

Report of Bullying --Ar'

Ie "Triad Local Schools: Successful learning today... productive living tomorrow. " )

Dr. Craig M. Meredith Connie CohnSuperintendent Treasurer

Fighting Cardinals

Triad Local Schools7920 Brush Lake Road, North Lewisburg, Ohio, 43060

Board Office (937) 826-4961 Treasurer’s Office (937) 826-4004 FAX (937) 826-3281

“Triad Local Schools: Successful learning today... productive living tomorrow.”

Semi Annual Reporting FormActs of: Verified Acts of Harassment, Intimidation, and/or Bullying

** Please copy this page if needed **District School Triad Elementary pg 1

Category DateReported

DateVerified

Location Resolved

Verified Harassment -- XVerified Intimidation -- X

Verified Bullying -- XReport of Harassment -- Report of Intimidation --

Report of Bullying --

2/8/12 2/8/12 Classroom -- School Property -- X

Bus to School -- Bus home from School --

School Sponsored Event --

Yes or No

Verified Harassment -- XVerified Intimidation --

Verified Bullying -- Report of Harassment -- Report of Intimidation --

Report of Bullying --

3/2/12 3/6/12 Classroom -- XSchool Property --

Bus to School -- Bus home from School --

School Sponsored Event --

Yes or No*Consequence

delivered –child

continued toharass

Verified Harassment -- Verified Intimidation --

Verified Bullying -- Report of Harassment -- Report of Intimidation --

Report of Bullying -- X

3/13/12 3/16/12 Classroom -- School Property -- X

Bus to School -- Bus home from School --

School Sponsored Event --

Yes or No

Verified Harassment -- Verified Intimidation --

Verified Bullying -- Report of Harassment -- Report of Intimidation --

Report of Bullying -- X

3/13/12 3/16/12 Classroom -- School Property -- X

Bus to School -- Bus home from School --

School Sponsored Event --

Yes or No

Verified Harassment -- Verified Intimidation --

Verified Bullying -- XReport of Harassment -- Report of Intimidation --

Report of Bullying --

4/26/12 4/27/12 Classroom -- XSchool Property -- X

Bus to School -- Bus home from School --

School Sponsored Event --

Yes or No

Dr. Craig M. Meredith Connie CohnSuperintendent Treasurer

Fighting Cardinals

Triad Local Schools7920 Brush Lake Road, North Lewisburg, Ohio, 43060

Board Office (937) 826-4961 Treasurer’s Office (937) 826-4004 FAX (937) 826-3281

“Triad Local Schools: Successful learning today... productive living tomorrow.”

Semi Annual Reporting FormActs of: Verified Acts of Harassment, Intimidation, and/or Bullying

** Please copy this page if needed **District School Triad Elementary pg. 2

Category DateReported

DateVerified

Location Resolved

Verified Harassment -- XVerified Intimidation -- X

Verified Bullying -- Report of Harassment -- Report of Intimidation --

Report of Bullying --

1/31/2012 1/31/2012 Classroom -- XSchool Property --

Bus to School -- Bus home from School --

School Sponsored Event --

Yes or No

Verified Harassment -- Verified Intimidation -- X

Verified Bullying -- XReport of Harassment -- Report of Intimidation --

Report of Bullying --

2/15/12 2/15/12 Classroom -- School Property -- X

Bus to School -- Bus home from School --

School Sponsored Event --

Yes or No

Verified Harassment -- XVerified Intimidation -- X

Verified Bullying -- XReport of Harassment -- Report of Intimidation --

Report of Bullying --

2/24/12 2/24/12 Classroom -- XSchool Property --

Bus to School -- Bus home from School --

School Sponsored Event --

Yes or No

Verified Harassment -- Verified Intimidation --

Verified Bullying -- Report of Harassment -- Report of Intimidation -- X

Report of Bullying --

3/16/12 Was notreallyverified –storiesdiffered

Classroom -- XSchool Property --

Bus to School -- Bus home from School --

School Sponsored Event --

Yes or No

Verified Harassment -- Verified Intimidation --

Verified Bullying -- XReport of Harassment -- Report of Intimidation --

Report of Bullying --

3/30/12 4/13/12 Classroom -- XSchool Property --

Bus to School -- Bus home from School --

School Sponsored Event --

Yes or No

Dr. Craig M. Meredith Connie CohnSuperintendent Treasurer

Fighting Cardinals

Triad Local Schools7920 Brush Lake Road, North Lewisburg, Ohio, 43060

Board Office (937) 826-4961 Treasurer’s Office (937) 826-4004 FAX (937) 826-3281

“Triad Local Schools: Successful learning today... productive living tomorrow.”

Semi Annual Reporting FormActs of: Verified Acts of Harassment, Intimidation, and/or Bullying

** Please copy this page if needed **District School Triad Elementary pg. 3

Category DateReported

DateVerified

Location Resolved

Verified Harassment -- XVerified Intimidation -- X

Verified Bullying -- XReport of Harassment -- Report of Intimidation --

Report of Bullying --

4/17/12 4/17/12 Classroom -- XSchool Property -- X

Bus to School -- Bus home from School --

School Sponsored Event --

Yes or NoLaw

Enforcementcontacted

Verified Harassment -- Verified Intimidation -- X

Verified Bullying -- Report of Harassment -- Report of Intimidation --

Report of Bullying --

5/4/12 5/4/12 Classroom -- XSchool Property --

Bus to School -- Bus home from School --

School Sponsored Event --

Yes or No

Verified Harassment -- XVerified Intimidation --

Verified Bullying -- XReport of Harassment -- Report of Intimidation --

Report of Bullying --

5/4/12 5/7/12 Classroom -- School Property --

Bus to School -- Bus home from School --

School Sponsored Event -- X

Yes or No

Verified Harassment -- Verified Intimidation --

Verified Bullying -- Report of Harassment -- Report of Intimidation --

Report of Bullying --

Classroom -- School Property --

Bus to School -- Bus home from School --

School Sponsored Event --

Yes or No

Verified Harassment -- Verified Intimidation --

Verified Bullying -- Report of Harassment -- Report of Intimidation --

Report of Bullying --

Classroom -- School Property --

Bus to School -- Bus home from School --

School Sponsored Event --

Yes or No