Anonymous Reporting Tip Line
Please use this form for communicating bullying, harassment, and concerns. Your communication can be anonymous or you are welcome to include contact information to allow us to ask additional questions if needed.
If you believe someone is in immediate and life-threatening danger, please indicate below. *
Your name: (optional)
Your answer
I am a: (If other, please specify in the area provided.) *
I have reported this event/situation to my school: *
Please indicate the type of report: *
Name of person (bullied or harassed): *
Your answer
School or location person attends: *
If known, name of person doing the bullying or harassing. *
Your answer
Were you present when the incident occured? *
List of other students or adults who witnessed the incident or situation: (If no witness, enter NONE) *
Your answer
Who has been told about they incident or situation? *
Where did the incident occur? (Check all that apply) *
What date did the incident occur? *
Please describe in detail what happened: (include when and where the incident occurred) *
Your answer
Best way to contact you: *
Never submit passwords through Google Forms.
This form was created inside of Alexander County Schools. Report Abuse - Terms of Service