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Hereford ISD - Bullying Reporting Form
Hereford ISD has a zero-tolerance policy for bullying. You may report bullying here and be anonymous.
This from may be used by any student or adult to report 'mistreatment by others' at Hereford ISD Schools. This may include alleged bullying, harassment, discrimination, injury or cyber related incidents.
Contact Info - NOT required but preferred
Name & Home Phone / Cell Phone / Email / Homeroom
Which campus did the incident happen at?
Tierra Blanca Elementary
West Central Elementary
Hereford Jr. High School
Hereford Prepratory Academy
Hereford High School
Hereford Center for Accelerated Learning
Stanton Learning Center
Name of the adult(s) you've already contacted (if any):
Self / Parent / Friend / Teacher / Bystander / Etc. of the victim.
Name(s) of accused:
Who is bullying you?
Where did the incident happen?
Select locations(s) - if Other please explain.
Outside / Playground
Please check the box that best describes what the accused did.
Please choose all that apply and if "Other" is selected please explain.
Physical: Hitting, Kicking, Shoving, Spitting, etc.
Teasing: Name calling, put downs, criticizing, inappropriate jokes, etc.
Threatening in person, by phone, by email, etc.
Excluding or rejecting the student.
Demanding money, homework, etc.
Getting another person to hit or harm the student.
Property Issues: hiding, damaging, taking, etc.
Making rude and/or threatening gestures.
Spreading harmful rumors or gossip.
Describe what happened. Use all exact language and as much detail as possible. Please include any web address or screen names that would help us in an investigation.
If I were watching it on a video, what exactly would I see?
I agree that all of the information on this form is accurate to the best of my knowledge.
By clicking one of the options below is like having your signature.
YES - I AGREE
NO - I DON'T AGREE
Please add your first name, last name, a telephone number, or email address if you would like to be contacted by School Administrator.
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