Anonymous Reporting - Melissa Ridge Education Center

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At Melissa ISD, we are committed to providing a safe and nurturing learning environment for all students, families and staff members. In everything that we do, we strive for a unified school community instilling our core values and character traits, which we also call “the Cardinal Way”.

If a student does not feel safe or secure at school, we want to know about it. Our schools have a reporting process in place to assist students and families with sharing any concerns, including: bullying, harassment, threats, self-harm, acts of racism, violence or unlawful activities. It is required that the requested information be provided to determine whether the allegations, if proven, would constitute prohibited conduct as defined by our MISD Board Policy.

Reported by (Optional):

Email (Optional):

Phone Number (Optional):

Reporting Date: *

YYYY

Are you a: *

Type of Offense: *

Bullying - Behavior that is harmful, damaging, intimidating, threatening, or abusive, and is severe, persistent, and pervasive

Harassment - Consistent, persistent unwanted attention

Discrimination - Being treated unfairly because of your race, color, religion, sex, gender, national origin, age, or disability

Threat to Harm Themselves or Someone Else

Name of the Student being Targeted: *

Grade of Student being Targeted: *

Name(s) of Student(s) Carrying out the Bullying, Threat or Harassment: *

Grade of Student Carrying out the Bullying, Threat or Harassment: *

Witness(es) of Alleged Bullying, Threat or Harassment (Optional):

Grade of Witness (Optional):

Date of Incident: *

YYYY

Time of Incident: *

Time

Location of Incident *

Please provide a detailed explanation of the incident and any additional information that could be useful during the investigation: *

Please include the name of social media platform and username if applicable.

The Reported Information is True/Accurate: *

YES

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