Anonymous Bullying Report Form
Bullying is a serious issue and will not be tolerated at Walker-Hackensack-Akeley schools.  Use this form to report bullying that occurred on school property, on the bus, was a part of a school event, on social media or through text message, email or other apps, during the school day.

In order to be considered bullying, the behavior must be aggressive and include:
An Imbalance of Power:
Kids who bully use their power—such as physical strength, access to embarrassing information, popularity—to control or harm others.

Power imbalances can change over time and in different situations, even if they involve the same people.

Repetition: Bullying behaviors happen more than once.

Bullying reports can be completed via this form, or through the use of an Anonymous Bullying Documentation Form (which can be found in the office.)
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Your  Name  (optional)
Date Today
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I am a:
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Phone Number (Optional)
Email Address (Optional)
Student(s) who was harmed (please provide name(s) and grade(s):
Student(s) who did the harm (please include name(s) and grade(s):
Date of Incident
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DId you witness the incident?
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Did any other students or adults witness the incident?
Time of Incident
Time
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Location of Incident
Nature of Bullying Being Reported
Did the Bullying Include Mean Comments About You or Other Students?
Please provide the office with any other details about the incident that you feel are important.
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