Reporting Form

Definition: Bullying occurs when a person is exposed, repeatedly and over time, to negative actions on the part of one or more other persons, and he or she has difficulty defending himself or herself. It is aggressive behavior that involves unwanted, negative actions. It involves a pattern of behavior repeated over time. It involves an imbalance of power or strength.
Name of person making report (not required):
Your answer
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Name/grade of the alleged aggressor(s): *
Your answer
Name/grade of the person(s) targeted by the aggressor: *
Your answer
Date(s) & Time(s) of incident(s): *
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Time
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Incident location (be as specific as possible): *
Your answer
Type of harassment alleged (check all that apply) *
Required
Describe the incident in detail, including the name of the person(s) involved, what was said and done, and specific words used. *
Your answer
Witnesses (List people who saw the incident or have relevant information about the incident):
Your answer
Prior Documented Incidents *
Required
Date:
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Time
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