Dudley Elementary Bullying Report Form
Dudley Elementary is making every attempt to make our school a positive and safe learning environment.

Before you report: Bullying is any aggressive and unwanted behavior that is intended to harm, intimidate, or humiliate the victim; involves a real or perceived power imbalance between the aggressor or aggressors and victim; and is repeated over time, or causes severe emotional trauma.

Please tell us who YOU are *
Name of person(s) being bullied *
Your answer
What grade is the victim in? *
Name of person(s) doing the bullying *
Your answer
Describe what happened (please be specific) *
Your answer
When did this happen? *
Has this happened before? *
If it has happened before, please describe in detail what happened and the number of incidents.
Your answer
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