Anonymous Report Form - for reporting bullying & other incidents
"Bullying" means any severe or pervasive physical or verbal act or conduct, including communications made in writing or electronically, directed toward a student or students that has or can be reasonably predicted to have the effect of one or more of the following:
(1) placing the student or students in reasonable fear of harm to the student's or students' person or property;
(2) causing a substantially detrimental effect on the student's or students' physical or mental health;
(3) substantially interfering with the student's or students' academic performance; or
(4) substantially interfering with the student's or students' ability to participate in or benefit from the services, activities, or
privileges provided by a school.
Bullying may take various forms, including without limitation one or more of the following: harassment, threats, intimidation, stalking, physical violence, sexual harassment, sexual violence, theft, public humiliation, destruction of property, or retaliation for asserting or alleging an act of bullying. This list is meant to be illustrative and non-exhaustive.

Other incidents include, but are not limited to, any situation or information that would pose a danger to students, staff or facilities.

When did the incident occur?
MM
/
DD
/
YYYY
Where did the incident occur?
Check all that apply.
Required
Who is involved?
Your answer
Reported by
Describe the incident.
Be as specific and detailed as possible.
Your answer
Submit
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