CASLV Student Bullying or Harassment Reporting
Bullying and harassment are serious and will not be tolerated. This is a form to report alleged harassment or bullying that occurred on school property; at a school sponsored activity or event off school campus; on a school van; or on the way to and/or from school, in the current school year. If you are a student victim or a friend of student who is getting harassed or bullied and wish to report and incident of alleged harassment or bullying, complete this form and submit it.

BULLYING (as defined by the CASLV Schools Handbook), is considered, but not limited to, any of the following: verbal, cyber or physical harassment or threat there of, taunting, hazing, intimidating or any other action whereby one or more individuals deliberately single out another student for cruel, mean and/or humiliating treatment. For more detailed information regarding disciplinary actions associated with bullying, please see the full handbook at

If this is an URGENT bullying matter or an EMERGENCY, please speak directly to an administrator.

Student Reporting the Incident:
Your answer
The Date the Incident Occurred
Name of the Student the incident happened to:
Your answer
Was an adult near at the Time?
If so, who was the adult?
Your answer
Please list any other witness(es) of the incident:
Your answer
Where did the incident happen:
Your answer
Name(s) of the Student(s) allegedly causing the problem:
Your answer
Campus that the Student attends:
Please Describe the incident, be as detailed as possible:
Your answer
Email Address *
Your personal information is optional and will remain confidential to the extent permitted by law.
Your answer
Phone Number *
Your personal information is optional and will remain confidential to the extent permitted by law
Your answer
Never submit passwords through Google Forms.
This form was created inside of Coral Academy of Science Las Vegas. Report Abuse - Terms of Service - Additional Terms