Floyd T. Binns Bullying Report Form
Students from FT Binns may use the form below to report a bullying event that was witnessed at school or on school property (to include bus stops). Please take a moment to fill out the form and submit it to our school counselors who will review every submission.
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What is your last name? *
What is your first name? *
Please include an email or phone number we can respond to you with. *
Please select one *
Please describe the bullying event. Include persons involved and everything that happened in as much detail as you can remember. *
What day did this occur? *
MM
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DD
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YYYY
About what time did this occur? (Give an approximate time if you can't remember) *
Time
:
Where did this happen? On the bus, in the hall, before or after school?  Be as specific as possible. *
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