Online Bullying Reporting Form
IF YOU ARE IN IMMEDIATE DANGER, CALL 911.
East Nicolaus High School is committed to providing a safe, comfortable learning environment for all students. Bullying incidents can be reported directly to a trusted staff member at your school. This online form may also be used by East Nicolaus students students to report being bullied or by someone witnessing a student being bullied. For more information about this online form, please see our Frequently Asked Questions @
Once submitted, the investigation process will begin within five (5) working days. Keep in mind, this process can only be as thorough as the information provided. If you do not want the form to go to the school’s principal, contact the Office at (530) 656-2255 to report bullying and do not complete this form.
Sign in to Google
to save your progress.
Location where incident occurred (optional)
Person Reporting Incident
Select which apply to you (optional)
Name(s) of alleged offenders (optional)
Please describe the bullying incident. Try to include as many details as possible (optional)
Check all that apply *
Please indicate if you think the incident was motivated by:
By completing this form, you are verifying that your statements are true and accurate to the best of your knowledge.If you have trouble completing this form and would like to speak with someone, contact the School Office at (530) 656-2255.
Page 1 of 1
Never submit passwords through Google Forms.
This form was created inside of East Nicolaus High School.