Bullying Report Form for South Gibson School Corporation
Bullying means intentional unwanted repeated acts or gestures involving physical, verbal, social, and electronic/written communications.
Reporter's Information
Reporter's First & Last Name
Your answer
Reporter's Grade
Reporter's School Building
Reporter's Role
Have you reported this to a teacher or staff member at your school building?
If yes, what is that teacher or staff member's name?
Your answer
Elements of Bullying
Has there been a history between the individuals?
Is there an imbalance of power between the individuals?
Repetition: has this or a similar incident happened before? Is the victim worried it may happen again?
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