Bully Report Form
"Bullying involves a desire to hurt, intimidate, a power imbalance, repetition, an unjust use of power, evident enjoyment by the aggressor and a sense of being oppressed on the part of the target" (from the MGSD Code of Conduct).
Students can use this form to report bullying to their school counselors. School counselors will follow-up with the victim as soon as possible. We will *never* tell the bully who made the report -- your safety is our priority.
Victim's First Name
Victim's Last Name
Victim's Grade Level
7th - Mr. Genson is my school counselor
8th - Ms. Royal is my school counselor
Bully's First Name
Bully's Last Name
Date of Most Recent Occurrence
Location of Most Recent Occurrence (include details such as room number, hallway, bus number, lunch table number, etc)
Witnesses to Most Recent Occurrence (Include first and last names, if possible. We may need to contact them to ask questions.)
Describe the bullying in as much detail as possible.
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