Suspected Bullying Report Form
Please answer the questions below as completely as possible, and then click the submit button
Who is the Target of the Bullying behavior?
Please list the person or persons who are exhibiting the Bullying behavior
Please list anyone who may have seen what happened
Please select the type of bullying behavior
(Check all that apply)
Name-calling or mean teasing
Name-calling or mean comments about race or color
Name-calling or mean comments, or gestures with a sexual meaning
Taking another's property
Please describe the incident
Where did the incident take place
Please include your name as the person reporting the incident (Optional)
Although optional it is helpful to know who is reporting the incident.
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This form was created inside of Delaware Academy Central School District.