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Report Bullying or People being Unkind
This form is intended for you to be able to report bullying or any other unkind behavior. You can report things that have been done to you or a classmate. We will keep your name confidential.
Thank you for standing up and doing what's right !
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Your last name:
Your answer
Your first name:
Your answer
Grade
6
7
8
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Date that the incident occurred
MM
/
DD
/
YYYY
Where did this happen?
Classroom
Hallway
Bus
Cafeteria
Gym
Other
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Last name of the person being unkind (if you know it)
Your answer
First name of the person being unkind
Your answer
Describe what happened. Please provide as many details as you can about what happened.
Your answer
Were there any witnesses? Who?
Your answer
Do you have any others concerns or anything you would like to share?
Your answer
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