Bullying and Harassment Reporting Form
Bullying and harassment are serious and will not be tolerated. This is a form to report alleged harassment or bullying that occurred on school property; at a school sponsored activity or event off school campus;or on the way to and/of from school, in the current school year. If you are a student victim or a friend of student who is getting harassed or bullied and wish to report an incident of alleged harassment or bullying, complete this form and submit it the Dean of Discipline, or the front office.

BULLYING (as defined by the School of Science and Technology-Corpus Christi), is considered, but not limited to, any of the following: verbal or physical harassment or threat there of, taunting, hazing, intimidating or any other action whereby one or more individuals deliberately single out another student for cruel,mean and/or humiliating treatment. For more detailed information regarding disciplinary actions associated with bullying , please see the handbook on our school website.

It is an URGENT bullying matter or an EMERGENCY, please speak directly to an administrator.

STUDENT REPORTING THE INCIDENT
Your answer
TODAY'S DATE
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YYYY
WAS AN ADULT NEAR AT THE TIME?
IF SO, WHO WAS THE ADULT?
Your answer
NAME OF THE STUDENT THE INCIDENT HAPPENED TO:
Your answer
THE DATE THE INCIDENT OCCURRED?
Your answer
TIME OF THE DAY THE INCIDENT OCCURRED:
Your answer
WHERE DID THE INCIDENT HAPPENED:
Your answer
NAME OF THE STUDENT CAUSING THE PROBLEM:
Your answer
IS THERE ANY ADDITIONAL INFORMATION THAT YOU WOULD LIKE TO PROVIDE?
Your answer
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