USD 113 Anonymous Bullying Report Form
The staff and administration of USD 113 is dedicated to the prevention of bullying and the kind treatment of all people. Thank you for taking the time to report bullying when you see it. This form does give an opportunity for you to identify your name, but this is NOT required. We only ask for it in case we need to follow up for more information. Please be as complete as possible as you fill out the form.
Date Report is Being Submitted (today's date)
Date of the Bullying Event You are Reporting
Name(s) of the person or people doing the bullying?
Grade of the person or people doing the bullying?
School where the bullying person attends.
Axtell Public Schools
Sabetha Elementary School
Sabetha Middle School
Sabetha High School
Wetmore Attendance Center
Name of the person being bullied.
Grade of the person being bullied.
What type of bullying are you reporting?
Damage to property
Where did the bullying happen?
More details about the location
If you're able to give exact details about the location of the bullying event, do so here.
Describe the bullying event.
Give as much detail as you can about what happened.
Optional: Name of Person Reporting the Bullying
May we contact you if more information is needed?
If you'd like a copy of this report emailed to you, enter your email here.
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This form was created inside of USD #113 Prairie Hills.
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