Alief ISD Report Bullying Form
Thank you for taking the time and having the courage to make a Bullying Report. Alief ISD is committed to providing a safe environment for all students. Bullying is a serious offense, and reports will be taken seriously. Please read the definition of bullying below before making a report.

Please note, this form should not replace face-to-face meetings or telephone conversations. If your message is urgent, please contact the Alief ISD Police Department at 281-498-3542.

What is Bullying?
Defined in the Education Code as a single significant act or pattern of acts by one or more students directed at another student that exploits an imbalance of power and occurs when a student or group of students engages in written or verbal expression through electronic means, or physical conduct against another student that:

- Has the effect or will have the effect of physically harming a student, or damaging the student's property; or
- Places a student in reasonable fear of physical harm to the student's person;
- Is sufficiently severe, persistent, or pervasive enough that the action or threat creates an intimidating, threatening, or abusive educational environment for that student;
- Materially and substantially disrupts the educational process or the orderly operation of a classroom or school; or
- Infringes on the rights of the targeted student at school.

Bullying includes cyberbullying.
This state law on bullying prevention applies to:

- Bullying that occurs on or is delivered to school property or to the site of a school sponsored or school-related activity on or off school property;
- Bullying that occurs on a publicly or privately owned school bus or vehicle being uses for transportation of students to or from school or a school-sponsored or school-related activity; and
- Cyberbullying that occurs off school property or outside of a school-sponsored or school-related activity if the cyberbullying interferes with a student's educational opportunities or substantially disrupts the orderly operation of a classroom, school, or school-sponsored or school-related activity.

Alief ISD Report Bullying Form
School: *
Please list the first and last name of the person who is being bullied/cyberbullied. Note: If you do not know the person's full name, include as much of the person's name as possible. *
Your answer
Please select the grade level of the person who is being bullied/cyberbullied.
If possible, please list the first and last name of the person who you believe is bullying. Note: If you do not know the person's full name, include as much of the person's name as possible. *
Your answer
Where did this incident occur?
Did this event occur via an electronic device? *
Please indicate the date of the most recent incident.
MM
/
DD
/
YYYY
Please indicate the approximate time of the most recent incident.
Time
:
How many times has this situation occurred? *
Have you reported this incident to an adult? *
Describe the bullying. Please give as much information as you can, including any witnesses. *
Your answer
Can we contact you regarding this report? *
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