Richland #44 Bullying Report Form

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If you have witnessed or heard about bullying (or think something might be bullying), please fill out this form. You can include your name or stay anonymous. Please know that if you remain anonymous, we will not be able to follow up with you for additional questions. Richland #44 administration will follow up with all reported incidents of bullying.

I am a... *

Student

Parent

Staff member

Community member

Other

Name (optional):

How did you learn about the potential bullying? *

I was the victim.

I was the bully.

I witnessed it.

I heard about it.

When did this happen?

Where did it happen?

Please describe what happened. *

Is there anything else you would like to share?

Would you like us to contact you? If so, please include your preferred contact information.

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