Anonymous Bullying Reporting Form 2024-25

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If you have information regarding bullying and would like to report this information anonymously, please fill out the following form to the best of your knowledge.

**Please Note: Students are prohibited from deliberately making false reports of bullying, harassment, threats, or intimidation. Those who make false reports will be subject to disciplinary action according to the Code of Conduct and Ohio Revised Code.**

What date did the alleged bullying incident occur? *

Who do you believe was bullied?

Who do you believe was the bully (or bullies)?

Where did the incident happen? Check all that apply.

On school property

At a school sponsored activity

On the school bus

At a bus stop

On the way to/from school, but not on the bus

Online

Other:

Clear selection

Put a check next to the statement(s) that best describe(s) what happened. Check all that apply.

Teasing

Threatening

Physical Violence

Name Calling

Social Exclusion

Intimidation

Theft

Sexual Harassment

Cyber Bullying

Stalking

Public Humiliation

Other:

Clear selection

Please describe what happened in as much detail as possible.

Do you know any of the witnesses involved? If so, please provide as much detail as possible about these people.

Is this report based on your honest belief that the student listed above as the victim has been bullied/cyberbullied and, to the best of your knowledge, is the information submitted a true and accurate representation of events? *

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