Alleged Bullying Report - Knippa ISD
It is required that the requested information be provided to determine whether the allegations, if proven, would constitute prohibited conduct as defined by policy. Name and contact information is optional. Your allegation of bullying will be investigated in compliance with KISD Board Policy.
Email address *
Phone Number
Your answer
Reporting Date *
MM
/
DD
/
YYYY
Are you a *
Name of the Student being Bullied *
Your answer
Grade of Student being Bullied *
Name(s) of Student(s) Carrying out the Bullying *
Your answer
Grade of Student Carrying out the Bullying *
Date of Incident:
MM
/
DD
/
YYYY
Time of Incident:
Time
:
Frequency of Bullying *
The Bullying Pertains to
Please provide a detailed explanation of the incident and any additional information that could be useful during the investigation *
Your answer
Location of Incident *
The Reported Information is True/Accurate *
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