Bullying Report Form/Formulario de Acoso

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The purpose of this form is to support students and make them feel comfortable in our school community

First & Last Name of the student/Victim

Nombre y Apellido del estudiante/Victima

Victim Class

Clase de la Víctima

Name of the bully (s) or description

Nombre del acoso o descripción

Type of Bullying:

Tipo de acoso:

Verbal

Physical/fisico

Social bullying/social

Relational Aggression/ agrecion relacional

Other:

Required

Reported to school by

Reporte a la escuela por

Teacher/Maestro/a

Staff/Trabajador de la escuela

Parent/Padre

Student/Estudiante

Other:

Describe the incident:

Describe el incidente:

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