Windy Gap Bullying Incident Report Form
Windy Gap Elementary School is compelled to keeping our students safe. Before you report:
What is bullying? “any aggressive and unwanted behavior that is intended to harm, intimidate, or humiliate the victim; involves a real or perceived power imbalance between the aggressor or aggressors and victim; and is repeated over time or causes severe emotional trauma."
* Required
Email address
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Your email
Please tell us who YOU are:
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Teacher
Student
Bystander
Victim
Parent
Bus Driver
Other:
Describe what happened:
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Your answer
When did this happen?
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MM
/
DD
/
YYYY
What time of day?
Time
:
AM
PM
Has this happened before?
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Yes
No
What grade is the (victim) in? Parents of any student involved in an allegation of bullying will be notified by the Principal.
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Pre-K
Kindergarten
1st grade
2nd grade
3rd grade
4th grade
5th grade
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