EVES Bullying Incident Report
Definition of Bullying: A person is bullied when he or she is exposed, repeatedly and over time, to negative actions on the part of one or more other persons, and he or she has difficulty defending himself or herself.  Please use this form to report bullying.  If you would like to report a student conflict, mean moment, or friendship issue, please contact Mrs. Quinn or Mr. Smith in person, via email to cquinn@ojrsd.net or edsmith@ojrsd.net, or by phone 610-469-5106.
登录 Google 即可保存进度。了解详情
电子邮件地址 *
Person's name submitting this form: *
Today's date *
/
/
When did the bullying occur? *
What role did you play? *
Name of the student(s) being bullied: *
Name of the student(s) doing the bullying: *
Who else was there? *
Where did this happen? *
必填
What type of bullying occurred? *
必填
Describe what happened: *
Whom did you tell? *
必填
提交
清除表单内容
切勿通过 Google 表单提交密码。
此表单是在 Owen J. Roberts School District 内部创建的。 举报滥用行为