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Compass High School Anonymous Report of Bullying, Harassment, and/or Intimidation
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Name
Your answer
Title/Position
*
Student
Staff Member
Parent/Guardian
Student(s) Person(s) Accused of Exhibiting Bullying, Harassment, and/or Intimidation Behavior:
*
Your answer
Student(s) Alleged to be the Target of Bullying, Harassment, and/or Intimidation Behavior:
*
Your answer
Check all boxes that best describes the behavior reported:
*
Physical aggression or contact to a pupil
Teasing or name calling
Insulting or demeaning comments
Threatening comments, gestures, or physical acts
Spreading harmful rumors or gossip about a pupil
Getting another person to harm a pupil
Harassment, intimidation or bullying through electronic communications
Destruction of property
Theft
Other:
Required
Location of incident
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Gazebo
Kiva
Parking lot
ILC
Classroom (Please specify in the following question)
Other (Please specify in the following question)
Please describe below the details of the incident you are reporting:
*
Your answer
Please list below the name(s) of any person(s) you believe either witnessed or have knowledge of the incident you are reporting:
*
Your answer
Did you file a verbal report with the Principal or designee on the same day of witnessing or receiving?
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Yes
No
I certify the information contained in this Report is accurate and true to the best of my knowledge
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