REPORT BULLYING NOW
If you or someone you know has been the victim of bullying please report it on the form below. The definition below outlines what exactly bullying can be:
What is "Bullying"?
This means a single significant act or a pattern of acts by one or more students directed at another student that exploits an imbalance of power and involves engaging in written or verbal expression, by electronic means (cyberbullying), or physical conduct.
Where can "Bullying" take place?
It can occur on school property, at a school-sponsored event or school-related activity, or in a vehicle operated by the
What effects can "Bullying" have on a student?
This involves physically harming a student, causing a student to experience substantial negative mental health
effects, damaging a student's property, or placing a student in reasonable fear of harm to the student's person or of
damage to the student's property; or is sufficiently severe, persistent, and pervasive enough that the action or threat creates an intimidating, threatening, or abusive educational environment for a student.
What can the impact of "Bullying" be?
It can materially and substantially disrupts the educational process or the orderly operation of a classroom or school; or infringes on the rights of the victim at school.
Sign in to Google
to save your progress.
1. What campus do you attend?
Big Country Elementary
Bob Hope Elementary
Christa McAuliffe Middle School
Elm Creek Elementary
Frances Scobee Middle School
Hidden Cove Elementary
Indian Creek Elementary
Judith Resnik Middle School
Kriewald Road Elementary
Medio Creek Elementary
Ronald McNair Middle School
Sky Harbour Elementary
Southwest Legacy High School
Southwest High School
Spicewood Park Elementary
Sun Valley Elementary
CAST STEM High School
2. What is the name of the alleged victim(s), or your name?
3. What is the name(s) of the alleged person(s) doing the bullying?
4. What is the name of the witness(es), you can put none if there was not any?
5. When did this incident take place?
6. Where did this incident take place?
On the Bus
7. Which of these best describes what type of alleged bullying you experienced?
Physical: hitting, pushing, shoving, slapping, kicking, spitting, beating up, or having property stolen
Threats: promising to cause physical harm to at a later time
Verbal: called names, teased hurtfully, insulted, humiliated, or threatened
Social: excluded from a group, made to look dumb by someone, gossiped about; rumors spread
Electronic: threatened, embarrassed, singled out, had feelings hurt, been gossiped about, or had secrets about you revealed through e-mail/text messages/pictures
Ethnic: treated differently or badly because of your race, culture, ethnic
Gender: left out or treated badly because you are a boy or a girl; heard sexist comments
Adult Oriented: incident involving an adult
8. Describe in detail, what allegedly happened to you or the person who was being bullied?
9. Is this the first time you(your friend) has been bullied by this person(s)?
Never submit passwords through Google Forms.
This form was created inside of Southwest ISD.