Report Bullying Incident
Use this form to report a bullying incident at Harrold ISD
Name (Leave this answer blank if you want this report to remain anonymous):
Email Address (Leave this answer blank if you want this report to remain anonymous):
Date of Incident (Note:If the exact date is unknown, give a date as close to the actual date as you can know)
Where did the incident occur?
Describe details about where the incident occurred (classroom teacher, bus number, area of playground, gym, etc.):
Type of Bullying
Specific details about type of bullying that are important to understand:
List any witnesses to the incident in this report:
Has this bullying incident been reported to any school personnel?
If "Yes" was answered to the previous question, list all school personnel to whom this incident was reported? If you marked "No" to the previous question, write "None" below.
Date(s) reported to school personnel. If the incident was not reported, write "None" below
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