JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Lowell Elementary Bullying, Intimidation, Harassment Reporting Form
Sign in to Google
to save your progress.
Learn more
* Indicates required question
I ________ of a bullying incident.
*
was the target
am a victim
was the witness
received a report of
I am a:
*
Student
Parent
Teacher
School Staff
Other:
The incident took place:
*
on school property
at a school sponsored event
on a bus or other school vehicle
off school property
Other:
Describe in detail the incident, including location, any injuries or damage to property, etc.
*
Your answer
Was this an isolated incident?
Yes
No
Other:
Clear selection
If No, how many other incidents have there been?
Yes
No
Other:
Clear selection
Aggressor Name
*
Your answer
Other Affected Students:
Your answer
Optional: Name of person making report
Your answer
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Missoula County Public Schools.
Report Abuse
Forms
