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Stacey Jr. Senior High Bullying Report Form
Thank you for reporting bullying. We have a zero tolerance policy for any type of bullying at our school. If you feel you are in immediate danger, please contact the nearest adult. You can contact our Junior High Counselor, Mrs. Nicholson, at 210-357-5108 (
), our Senior High Counselor, Mrs. Medellin-Keller, at 357-5102
), or our Vice Principal, Mr. Shelby, at 357-5104 (
Who is the victim?
What is the bully's first and last name?
What kind of bullying is it?
Social Network (Facebook, Twitter)
How many ways have they bullied you?
Is it one individual or a group of people bullying you?
How long has this been going on? Or is it frequently happening?
Do you and the bully have a history of problems?
Where is the bullying taking place?
Did the bully have weapons?
Are there any witnesses?
What kind of steps have you taken?
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