Report bullying and harassment-Harvest Intermediate School 23-24
This is a way for you to report bullying and harassment happening at Harvest. If this is an immediate safety concern, please do not use this form and tell an adult in the building right away. Your student advocate will check in with you as soon as they can. Please give them up to 24 hours to check in with you.
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Where did the incident occur? *
When did it happen?  *
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What time did it happen? *
Time
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How many times has this situation happened? *
Have you reported this incident to an adult? *
Who was bullying, harassing, intimidating or causing harm? 
FIRST and LAST NAME 
 *
What grade is the person who was causing harm in? *
Who was the person being harmed, bullied, harassed or intimidated? 
FIRST and LAST NAME
 *
What grade is the person who was being harmed in? 
 *
Describe what happened. Give as much information as you can.
 *
Who witnessed this event?
 *
Who are you? *
What is your name?
 *
If you are not a student at this school and would like someone to contact you, please add your phone number here. (Optional)
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