Bully Reporting-Westerly High School
Your Name (optional, but helpful):
I am a:
Describe the situation:(include info on the bullly, victim, any witnesses/bystanders; the more detail you provide the better)
Select the statement(s) that you believe best describe what happened. (choose all that apply)
Involves physical aggression.
Making rude and/or threatening gestures.
Pattern of excluding or rejecting a student.
Intimidating (bullying) and/or extorting.
Threats and/or retaliation
Spreading harmful rumors/gossip
Electronic Communications used to bully (select all that apply):
Harassment (select all that apply)
Location(s) (select all that apply):
Date and Time this happened:
What sort of help would you like with this issue?
Have you told anyone else about this incident? Who?
Never submit passwords through Google Forms.
This form was created inside of Westerly Public Schools.
Terms of Service