Offensive Incident Report From
What is Bullying? Bullying is when someone repeatedly and on purpose says or does mean or hurtful things to another person. Please share your concern with us if you have experienced a student not showing Tiger Pride.
Relationship to the person being bullied:
I am the person being bullied
Date(s) of Incident:
Type of Bullying?
Non-Verbal (exclusion, eye-rolling, etc...)
Who was Bullied? (Please list first and last names and grade level of all students, if reporting multiple students.)
Who did the Bullying? (Please list first and last names and grade level of all students, if reporting multiple students.)
Were there any bystanders? If yes, please list first and last name.
Where did it happen?
Time of day:
Bus / Bus Stop in the Morning
Lunch / Recess
Bus / Bus Stop after school
Has this happened before?
No, this is the first time
Yes, this has happen once before
Yes, this is an ongoing problem
Did a physical injury result from this incident?
Yes, but it did not require medical attention
Yes, and it required medical attention
Briefly describe the incident:
Please include any other information what we need to know:
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