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Drexel Bullying Report Form
If a bullying incident occurs, please fill out the information.  The more detail, the better.
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Name of Person Reporting (If you do not feel safe providing your name, leave it blank).
Date of Incident *
MM
/
DD
/
YYYY
Time of Incident *
Time
:
Location of Incident (Where did the bullying happen)? *
Name of person BEING bullied *
Name of person that is bullying *
Were there any witnesses or bystanders?  If so, list them here.
Type of Bullying *
Required
Bullying Behaviors, check all that apply *
Required
Describe the incident (use as much detail as possible). *
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