Gorman ISD Bully Report Form:  2023-2024

Texas Education Code (TEC) §37.0832 identifies bullying as a single significant act or a pattern of acts (repeated acts) by one or more students directed at another student that exploits an imbalance of power and involves engaging in written or verbal expression, expression through electronic means, or physical conduct and that

  • has the effect or will have the effect of physically harming a student, damaging a student's property, or placing a student in reasonable fear of harm to the student's person or of damage to the student's property;
  • is sufficiently severe, persistent, or pervasive enough that the action or threat creates an intimidating, threatening, or abusive educational environment for a student;
  • materially and substantially disrupts the educational process or the orderly operation of a classroom or school, or infringes on the rights of the victim at school.
Cyberbullying is bullying that involves the use of any electronic communication device, including through the use of a cellular or other type of telephone, a computer, a camera, electronic mail, instant messaging, text messaging, a social media application, an Internet website, or any other Internet-based communication tool

Please fill out the form below to report any incidents of bullying.  If you are unsure if the incident is bullying, please refer to the Texas School Safety Center flow chart to assist in determination.


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Email*
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Email *
Date of Incident *
Time of Incident
Repeat Infraction *
Location of Incident  *
Hallway
Restroom
Classroom
Gym
Cafeteria/Lunch Room
Playground/Areas between Buildings
Locker Room
Bus Stop
On Bus
Parking Lot
To/From School
After School Program
School Sponsored Event
Text/Phone/Internet/Social Media
Chose all that apply
Name of Victim or Victims: *
Name of student or students bullying *
Name of Witnesses or Bystanders *
Type of Bullying *
Verbal
Physical
Relational/ Social
Electronic/ Cyber
Check all that Apply
Bullying Behaviors (repeated behaviors) *
Shoved/ Pushed
Hit/ Kicked/ Punched
Threatened
Stole/ Damaged Possessions
Excluded
Taunting/ Ridiculing
Writing /Graffiti
Told Lies or Rumors
Staring /Leering
Intimidation /Extortion
Demeaning Comments
Cyber Using Text Messages
Cyber Using Email
Cyber Using Website
Cyber Using Social Media
Racial, Sexual, Religious or Disability
Check all that Apply
Reported to: *
Describe the incident: *
Physical Evidence?  Notes?  Email?  Grafitti?  Video/Audio?  Website?  Other? *
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