High School Confidential Bullying / Harassment Reporting Form
This confidential form will be submitted to building Administration and will be processed within 24-48 hours. If this is an emergency, please contact the High School Office immediately at 877-5600.
Student First Name *
Your answer
Student Last Name *
Your answer
Who is submitting this form? *
Required
Parent / Guardian Name
Your answer
Who is involved in the bullying or harassment event? *
Your answer
When did the event occur? *
Where did the event happen? *
Check all that apply
Required
Type of incident *
check all that apply
Required
I think this was motivated by: *
check all that apply
Required
Describe what happened: *
Your answer
Have you talked to anyone about this? *
If yes, who?
Did anyone else see what happened? *
If yes, please write their name(s):
Your answer
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