Report a Bully
Use this form to report bullying activity at your school.

Bullying means intimidating or offensive verbal or physical conduct toward a student, which may also involve electronic media, when such conduct is habitual or recurring.

Keep Our Schools Bully Free!
Please choose school where bullying took place
Date bullying incident occurred
MM
/
DD
/
YYYY
Time of incident
Time
:
Where did this take place?
Name of Victim
Your answer
Name of student(s) doing the bullying
Your answer
Name(s) of witnesses/bystanders
Your answer
Bullying Behavior
Please select which applies to you as the reporter of this incident
Please describe the incident in as much detail as possible
Your answer
Your Name (optional)
Your answer
Submit
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