PGHS Reports Bullying
What is the name of the student you would like to report? If you do not know the name please describe the student *
Your answer
When did the incident take place
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DD
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YYYY
About what time did the incident take place on the date stated above?
Time
:
Where did the incident take place? (Please be specific!) *
Your answer
Please describe the incident by providing details and information. Please be specific. *
Your answer
Were their witnesses to the incident? *
Please provide names or descriptions of the witnesses.
Your answer
Please describe the frequency with which this type of incident occurs. *
Please describe any evidence that exists of the bullying.
Letters, photos, texts, etc. If you can provide this please leave it with a counselor or a principal.
Your answer
I am a *
This questions allows us to better serve the students, parents, or community.
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