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Graham High School Bullying Report
Please let us know about any bullying that may be occurring in our school. We want to make sure our students feel safe.
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Today's Date
*
Your answer
Your Name: Optional
Your answer
Your Telephone Number and/or Email address: Optional
Your answer
Are you a:
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Parent
Student
Staff Member
Other
Name of Student being Bullied
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Your answer
Name of Alleged Offender
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Your answer
Date of the Incident
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Your answer
Where did the incident occur?
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Classroom
Bathroom
Hallway
Gym/Lockerroom
Cafeteria
School Sponsored Event: Athletic Event, etc
On the way to school or from school
Bus
Building (A,B,C,D,L,S,V,Fine Arts)
Guidance/Office
Other:
Required
Check the statement that BEST describes what happened.
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Hitting, kicking, shoving, spitting, hair pulling or throwing something
Getting another student to hit or harm the student(s)
Teasing, name-calling, making critical statements (racial comments, sexual orientation) or threatening a person or other means of communicating threats
Demeaning the victim and/or making jokes about the victim
Making rude and /or threatening gestures
Excluding or rejecting the student
Intimidating (bullying), extorting or exploiting
Spreading harmful rumors or gossip
Electronic Communication such as
Texting
Social Networks: Facebook, Twitter, MySpace
Webposting
Blogs
Email
Required
To your knowledge, has this been reported before?
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Yes
No
Not Sure
Is there any additional information that you'd like to provide?
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Your answer
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