Alpha Elementary Student Concern Reporting Form
Students have a right to report and should report, bullying, or harassment at school, whether they are a bystander/witness or a victim. This form will be shared with your school site administrators.
Email Address *
Your Name (Optional, if you feel comfortable sharing)
Were you a victim of a student rights violation, such as bullying or harassment? *
Did you witness a student rights violation, such as bullying or harassment? *
Did someone else tell you about a student rights violation, such as bullying or harassment? *
If someone else told you about this violation, what is their name? (optional, if you feel comfortable sharing):
Did anyone else witness this violation?
Clear selection
Please tell us who else (names) was there? (optional, if you feel comfortable sharing):
Did you or someone report this to an adult?
Clear selection
If yes, please tell us who you reported this to:
What is your concern?
Was this committed by a staff member or another student? *
When did this happen?
Clear selection
Where did this happen?
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Submit
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