ANONYMOUS BULLYING REPORT
This online bullying report was created so that people would have a safe way to report bullying and safety concerns. When a person really needs help we hope you will step up and send in a report. Sending in a false report makes it harder for your school to help the people who really need it.After you submit the form, this form/report sends an email to a school administrator with all of the details from your bully report.
Provide your contact information (name, email, etc.) if you would like. (optional)
Who are you? (optional)
Please choose the location where the incident happened.
Please provide us with the TIME and DATE that the incident happened.
How many times has this situation happened?
This is the first time.
One other time.
Once per month.
Once per week
Have you reported this incident to an adult?
Who was bullying, harassing, intimidating or causing harm? (Please include first name, last name and grade if possible.)
Describe what happened. Give as much information as you can. Let us know if there were any witnesses.
If you are not a student at this campus and would like someone to contact you, please add your phone number here. (Optional)
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This form was created inside of Taylorville Community Unit School District #3.
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