Harassment, Bully, or Threat Reporting Form
Be sure to click "submit" after answering the following questions.
* Required
I have reported this event to my school:
*
No
Yes
Required
Name of person allegedly being bullied, harassed, or threatened:
*
Your answer
Alleged location (select from drop-down list):
*
Choose
Atlantic Elementary School
Beaufort Elementary School
Beaufort Middle School
Bogue Sound Elementary School
Broad Creek Middle School
Croatan High School
East Carteret High School
Harker's Island Elementary School
Morehead Elementary School
Morehead Middle School
Morehead City Primary School
Newport Elementary School
Newport Middle School
Smyrna Elementary School
West Carteret High School
White Oak Elementary School
Date:
Your answer
Name of alleged aggressor (bully/threat):
*
Your answer
The alleged aggressor is a:
*
Student
School Employee
Required
Your Name (optional):
Your answer
I am a:
*
Student
School Employee
Parent/Guardian
Person being bullied
Community Member
Friend
Other:
Required
Type of Event (Select all that appy):
*
Physical-Hitting/kicking/other physical aggression
Verbal-Teasing, name-calling, put-downs, or other behavior that would hurt others' feelings or make them feel bad
Emotional/Exclusion-Starting rumors, telling others not to be friends with someone, or other actions that would cause someone to be without friends
Cyber Bullying-Using an electronic medium to engage in any previously mentioned bullying
Required
Description of events (Please be specific--Location/Date/Time):
*
Your answer
Did you witness the event?
*
No
Yes
Required
List other students/staff who witnessed the event:
Your answer
Submit
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