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School Safety/Bullying Report
For emergencies, dial 911.
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* Indicates required question
Please select at least one activity.
*
Drug Distribution
Eating Disorders
Explosives
Fighting
Gangs
Harassment
Hazing
Other
Planned School Attack
Self-Harm
Sexual Assault
Sexual Misconduct
Substance Abuse
Suicide Threats
Theft
Threats
Vandilism
Weapons
Your Name (Optional)
Your answer
Street Address (Optional)
Your answer
City (Optional)
Your answer
Telephone (Optional)
Your answer
Email (Optional)
Your answer
When did the suspicious or bullying activity occur?
*
MM
/
DD
/
YYYY
Was Social Media used to express the problem?
*
Yes
No
If yes, what social media platform was used? Enter Username/Handle/Email/Phone Number, if available:
Your answer
Describe what you observed in detail (who,what,when,where). Please provide as much information as possible, including description and identifiers, of vehicle(s) and person(s) involved, whether suspect or victim.
*
Your answer
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