Anonymous Reporting

This form allows students to communicate with school administrators.  While the district already has many programs to help students deal with challenges such as bullying behaviors, stress, peer pressure, and family problems, this form can help break the code of silence often experienced by students because it allows them to report concerns to administrators anonymously.  

IMPORTANT NOTE:  This is not a crisis line.  In cases of emergency, the site will direct students to call 911. 

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Which campus did the incident occur on? *
Date of Incident *
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Date of Report *
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YYYY
Who was the person(s) engaged in bullying? *
Grade of the person(s) who was the bully? *
Who was being bullied? *
Grade of the person(s) being bullied? *
What type of bullying was it? *
Required
Where did the incident take place? *
Required
Other location details: (Please explain the specific location details, such as which hallway, where on the Internet, what restroom, etc.) *
Describe what happened with as many details as possible. *
Person reporting the incident  (OPTIONAL): Please use your full name.
May we contact you for more information on this incident? *
If you want to leave your phone number or email, leave it here:
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