Trinity Lutheran School Anonymous Bullying Form
This form is anonymous and confidential and should only be used when you are feeling a real concern for the physical, social, and emotional well-being of yourself or a fellow student. Upon submission of this form, a request will be sent anonymously. If you feel this is an emergency, we encourage you to report this immediately to a trusted adult.
Please type below the name of the student that you are concerned about.
Who is the bully (bullies)?
Where did the incident that you are reporting happen?
Please describe the problem or incident that you witnessed/heard that you are concerned about.
What is the approximate date that this incident occurred?
How often is this occurring?
A couple of times per week
A couple of times per month
It has only happened once
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