Magnolia ISD Bullying Report Form
This report is a confidential report that will prompt an investigation into the incident described below. The completion of this report does not indicate either guilt or innocence. The investigation will lead administration to make that determination. All administrative responses to this report will be designed to stop inappropriate behavior.
Name of the person filing the report *
Your answer
Date
Your answer
For clarification purposes of the investigation, please provide contact information *
Your answer
Which of the following is correct?
(Please check the appropriate answer)
Check which best describes you.
Name of Aggressor
Your answer
Name of the target of the behavior
Your answer
What is the relationship of the target to the aggressor?
Your answer
Date of the incident
Your answer
What type of bullying is this?
What campus is involved?
Describe the incident *
Your answer
Names of witnesses
These are staff or students who may have direct information about the incident.
Your answer
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