Speak Up to Stop Bullying - Polk Elementary
Brazosport ISD seeks to empower students to take personal responsibility for eliminating bullying, including cyberbullying, within our schools and community. It is important for students to report bullying and cyberbullying when they observe or experience it as soon as possible, so school officials may take appropriate action. Parents, staff members, and community members who learn of bullying or cyberbullying incidents are also asked to report it as soon as possible, in support of a community-wide stance against this type of behavior.
Reports may be made by completing and submitting this form. Reports may also be made by calling the B*SAFE Hotline at 979.730.SAFE (7233) or by directly contacting a campus administrator. Eliminating bullying behavior is everyone's responsibility, and your involvement is appreciated.
Date of incident
Name of the person bullying
Grade of the person bullying
Name of the person being bullied
Grade of the person being bullied
Name(s) of bystanders and witnesses
Type of bullying
Damage to student's property
Location of bullying
Cellphone, Computer, or Internet
On the way to or from school
Describe what happened. Give as many details as possible.
List evidence of bullying (photos, text messages, internet postings, etc.)
Your name (reports may be made anonymously)
Your contact information (optional)
Select the response that best describes you.
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