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Fairview Bullying Report Form
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* Indicates required question
Name of Complainant/reporter (Optional: by law, reports may be anonymous)
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Status of Reporter
Student
Parent
School employee/coach/advisor
Other:
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Contact information for reporter (if reporter is student, contact information for parent/guardian)
Reporter phone number
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Cell phone
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Email
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Address
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Incident details
Name(s) of alleged target(s)
Your answer
Name(s) of alleged bully(ies)
Your answer
Relationship between alleged target(s)/bully(ies)
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Time(s) and location(s) of alleged incident(s)
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Names of witnesses
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Description of incident(s) *
*
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By submitting this form, I agree that the information I have provided is accurate and true to the best of my knowledge and belief.
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