BISD High School Anonymous Bullying Report Form

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You will never be identified as the person making the report. As part of the investigation you may be called to the office, if you list yourself as a witness.

Please use this form for Bullying Reports only. Any other concerns or questions should be reported directly to your campus or district personnel.

When did this happen? *

YYYY

Your Name (Optional)

Your Grade

9th

10th

11th

12th

Clear selection

Alleged Bully's Name *

Alleged Bully's Grade

9th

10th

11th

12th

Other:

Clear selection

Please chose one *

I was bullied.

I saw someone get bullied.

Where did this happen? *

Classroom

Hallway

Bathroom

Cafeteria

Outside

Social Media Page (Twitter, Instagram, etc.)

Bus

Locker Room

Internet

Other

When/Time did the bullying happen?

Before school

After School

Lunch

Between classes

During class

During nutrition break

Outside of School

Clear selection

Name of any bystanders/witnesses (optional)

Names of people the victim spoke to about the bullying (optional)

In as much detail as you can provide, tell exactly what happened.

What else would you like us to know?

Submit

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This form was created inside of Bosqueville ISD. Report Abuse

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