Report Bullying Witter Ranch
Please review the following important notes before reporting an incident:

1) If you're a student, don't forget to talk to your parents or guardians about the incident. If you need immediate help, contact your school's principal.

2) Help your school to help you. Give as much information as possible to your school so they can investigate.

3) Incident reports are confidential and viewable only by school staff and police.

4) False reporting of an incident is against state law and school policy.

What is your grade level? *
How long has the bullying been going on? *
Date of the latest incident (MM-DD-YYYY)? *
Your answer
Time of the incident?
Your answer
Please describe what happened. *
Please give us as much information as possible.
Your answer
Location of Incident *
Behaviors that you experience during the incident: *
Did anyone else witness this incident? *
Please check one box
Please list the name(s) of anyone who witnessed the incident(s).
Your answer
Have any school staff been notified about this incident? If so, who? *
Your answer
Would you like to be contacted? *
Your Name (optional)
Your answer
Your Email Address (optional)
Your answer
Your Phone Number (optional)
Your answer
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