Threatening Behavior Reporting Form
Examples include, but are not limited to:
Verbal: Name-calling, teasing, inappropriate sexual comments, taunting, and threatening to cause harm.
Social: Spreading rumors about someone, excluding others on purpose, telling other students not to be friends with someone, and embarrassing someone in public.
Physical: Hitting, punching, shoving, kicking, pinching, spitting, tripping, pushing and taking or breaking someone’s things.
What Teens Can Do
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Please check the type(s) of bullying you are reporting.
Physical Bullying/Threatening Behavior
Verbal Bullying/Threatening Behavior
Social Bullying/Threatening Behavior
Cyber Bullying/Threatening Behavior
Name of student being bullied
Who was bullying, harassing, intimidating or causing harm? (Please include first name, last name and grade if possible.)
Name(s) of witnesses
When it happened (if during a specific period please include in "other":
Shubert Pre-K School
Cornelius Court School
California Avenue Elementary School
Grand Avenue Elementary School
Northern Parkway Elementary School
Smith Street Elementary School
Walnut Street Elementary School
Lawrence Road Middle School
Turtle Hook Middle School
Uniondale High School
Alternative High School
Where it happened:
What Happened? Give as much information as you can. Let us know if there were any witnesses.:
Name of reporter (you can choose to remain anonymous)
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This form was created inside of Uniondale School District.