Bullying/Harassment Reporting
Sign in to Google to save your progress. Learn more
Target/Victim's Name (first AND last) *
Alleged Aggressor's Name *
Share as many details of the incident as possible Provide copies (ie. letters, photos, texts, posts, etc.) when possible
Date of the Incident
Where did the incident occur?  Be specific as possible (ie. on a bus, on the way to/from school, at a school-sponsored event) *
Please describe the incident, in as much detail as possible, what happened? *
Do you know any of the witnesses involved?   Give as many details as possible. *
Reporter's Name       If you prefer to remain anonymous, please state why
Can we use your name in our investigation, if we need to? *
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Southern Plains Education Coop.

Does this form look suspicious? Report