RECHS/RCS Bullying Report
Please let us know about any bullying that may be occurring in our school. We want to make sure our students feel safe. This information is reviewed regularly during school hours. If this is an emergency or needs immediate attention please contact your student's Principal or counselor directly.
Your name (optional)
Your telephone number and/or email address (optional)
Are you a:
Name of student being bullied:
Name of alleged offender(s)
Date of the incident
Name of any other person that could have seen the incident and could provide more information
Where did the incident occur (check all that apply)
School sponsored event: athletic event,etc.
On the way to or from school
Check the statement that BEST describes what happened:
Hitting, kicking, shoving, spitting, hair pulling, or throwing something
Getting another student to hit or harm the student(s)
Teasing, name-calling, making critical statements (racial comments, sexual orientation), or threatening a person or other means of communicating threats
Demeaning the victim and/or making jokes about the victim
Making rude and/or threatening gestures
Excluding or rejecting the student
Intimidating (bullying), extorting or exploiting
Spreading harmful rumors or gossip
Electronic Communication (please also select which type from below)
Social Networks: Facebook, Twitter, MySpace
To your knowledge, has this been reported before?
To your knowledge, has this type of incident happened with this student before?
Is there any additional information that you would like to provide?
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