Anti-Bully Help Request
Your First and Last Name (Optional - you don't have to give your name if you don't want to):
First and Last Name of Bully or Bullies:
Name of School you attend:
Where: (For example, social time, lunchroom, etc.)
What is the Bully doing:
When did it start:
How often is the bullying happening:
What would you like us to do to help (You can choose more then one thing if you want):
Talk with you about what you can do to stop the bullying on your own. If you choose this option make sure you give us your name at the top of this form.
Talk to the bully (without telling them your name).
Tell your teachers and hallway supervisors about the problem so they can watch the bully more closely. Adults can then try to "catch them in the act" and tell the bully to stop bullying when they see it happen.
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This form was created inside of North DuPage Special Education Cooperative.