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)
Your answer
Name(s) of student(s) accused of bullying and/or harassment: *
Your answer
Where did the incident happen (choose all that apply) *
Required
What did the alleged offender(s) say or do?
Your answer
Were there any witnesses? *
Required
If yes, who?
Your answer
Name of person completing this form (optional)
Your answer
Today's Date *
MM
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DD
/
YYYY
Submit
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