2024/25 MTRSD Bullying, Harassment, Sexual Harassment, or Discrimination Report

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Please use this form to report incidents of alleged bullying, harassment, sexual harassment, or discrimination.

Name:

Email: *

I am reporting an incident of: *

Bullying

Harassment

Sexual Harassment

Discrimination

Your relationship with target (victim): *

Self

Parent/Guardian

Sibling

Other relative

Classmate or friend

Other:

Name of the target (victim): *

Name of the accused, if known: *

Date and time of the incident: *

YYYY

Time

Please describe the incident in as much detail as possible: *

Where did this incident take place? *

Please list any names of witnesses: *

If the incident was reported, to whom was it reported to? *

Any other details or information that would be helpful:

I wish to make an anonymous report. By making this anonymous you are not going to receive follow up about the incident. *

Yes

Submit

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