Report a "Bully" Form

Request edit access

Franklin Community Schools (FCS) is committed to providing students a safe and nurturing environment. FCS has implemented an anonymous reporting system for anyone who is a victim of bullying or witnesses bullying at school. The form allows students, parents, and any community member to anonymously report bullying through a link on the FCS website.

Click "Submit" when finished. An email will be sent immediately to FCS administration. Thank you for helping make Franklin Community Schools a safer place for all students.

If this is an emergency, please call 911.

Your Name (optional)

Your answer

Name of the person being bullied. *

Your answer

Please select a location where the bullying incident occurred. *

If the bullying incident occurred on a school bus, please select "Other" and type in the bus number.

FCHS

FCMS

CBIS

Creekside

Needham

Northwood

Union

Webb

Other:

Please tell us the date and time of the incident. *

YYYY

Time

Please select the type of bullying that occurred.

Note: Select all that apply

Physical - Hitting/kicking/other physical aggression

Verbal - Teasing/name-calling/put-downs/behavior that would hurt others' feelings or make them feel badly

Emotional/Exclusion- Starting rumors/telling others not to be friends with someone/actions that would cause someone to be without friends

Cyber - Using an electronic medium to engage in any previously mentioned 'bullying'

Please give a detailed description of the incident.

Your answer

Please provide names of any witnesses to the incident.

Your answer

Submit

Never submit passwords through Google Forms.

This form was created inside of Franklin Community School Corporation. Report Abuse - Terms of Service

Forms