Please understand if you don't share your name, it is very hard for us to investigate. Only administrators see what is reported and your name will be kept confidential. Having your name will help us help you and your friends.
Who is completing this form? *
Homeroom/life skills teacher *
Description of the situation to the best of your ability. Please share as many details as you can. *
What do you want as a result of sharing this situation? *
How long has this been going on and/or how many times has this happened? *
Have you told an adult (teacher, social worker, office staff, principal, etc.) at school about this? *
Anything else you would like to share at this time?
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