Bullying Report Form

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Please report any type of bullying with this online form or leave a note in our Bullying Box located near the media center and office doors. If you would like your report to be anonymous (no one will know you filled it out), just leave the last question blank. You may talk with the principal or counselors, too, if you wish or have your parent call us at any time. Thank you for reporting when kids are unkind. We want to help!

Describe in detail WHAT happened: *

Describe in detail WHERE it happened: *

Describe in detail WHEN it happened: *

Please list the names of any witnesses that saw or heard this happen: *

Please list the first and last name of the person being bullied: *

Please list the first and last name of the person who is doing the bullying: *

Type your first and last name. (But this is optional!) We will make sure no one knows you reported even if you give us your name.

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