Fulton High School Student Safety Concerns
BULLYING, INTIMIDATION, AND HARASSMENT
Bullying, intimidation, and harassment diminish a student’s ability to learn and a school’s ability to educate. Preventing students from engaging in these disruptive behaviors is important .

Bullying and/or Intimidation is defined as: Repeated intentional behavior by an individual with power over the victim or victims. Such behavior may include, physical, verbal, written or electronic communication or conduct of a belittling or browbeating nature.

Please use this form carefully, think about what has happened and express yourself to the best of your ability.
Your Name (*This is required and will be kept confidential) *
Your answer
Date *
Your answer
Contact Info ( home/cell/email) *
Your answer
Name of adults you have contacted.
Your answer
Name of Accused *(This will be kept confidential) *
Your answer
Please check the box or boxes that best describe what the accused did. *
Required
Description of current incident. Include date and time *
Your answer
Where did the incident happen? *
If you marked "other" on the previous question, please explain.
Your answer
Please list any witness.
Your answer
Any previous incidents, please explain
Your answer
How did you respond to the incident?
Your answer
Submit
Never submit passwords through Google Forms.
This form was created inside of River Bend CUSD #2. Report Abuse - Terms of Service