Harassment, Intimidation, or Bullying Reporting Form
Any student can report bullying or harassment by talking to an administrator or completing this form and returning it to the principal. This form can be placed in the school's designated drop off spot for anonymous reporting.
Your Name (optional)
Name(s) of student(s) accused of bullying and/or harassment:
Where did the incident happen (choose all that apply)
On school property
On a school bus
At a school-sponsored activity or event off of school property
On the way to/from school
At the bus stop
On the computer
What did the alleged offender(s) say or do?
Were there any witnesses?
If yes, who?
Name of person completing this form (optional)
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