Bullying Report

Please complete the whole form, responding only to the questions that you feel comfortable answering and are able to answer accurately. You may choose to include your name or submit it anonymously. Please note that the district's ability to investigate an anonymous complaint may be limited, and the District prohibits retaliation against anyone who files a bullying report.
In as concise as possible, describe what happened or what is happening. Though the text spaces on this form appear small, you have around 900 characters to type a description. If you need more, you may submit this form again.
When did it happen? *
Where did it happen. If "other" please describe it. *
 
Did anyone else witness the bullying? If yes, please list the names if possible. *
 
Was there damage to anyone's personal property? *
 
Have you or the victim missed any school or made any changes to your daily routine as a result of the incident(s)? *
 
Have you told anyone about the bullying? *
 
Have you previously filed a bullying report? (This information is used to determine if retaliation is occurring.) *
If you wish you can leave a phone number for us to contact you.
 
If you wish, you may leave an email address for us to contact you.
 
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