Anonymous Bullying Report Form- Reporte Bullying Anonimamente
Southwest Dubois is committed to providing students with a safe and nurturing learning environment.  This form is provided to allow for the anonymous report of a bullying incident.  This form will allow the Southridge High School staff to investigate any allegations and, if they are substantiated, pursue the proper course of action in response to a report of bullying.  
Southwest Dubois se compromete a proporcionar a los estudiantes un entorno de aprendizaje seguro y enriquecedor. Este formulario se proporciona para permitir el informe anónimo de un incidente de intimidación. Este formulario permitirá que el personal de Southridge High School investigue cualquier acusación y, si se corrobora, siga el curso de acción adecuado en respuesta a un informe de intimidación.
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School Building *
Name of Victim/Victims
Nombre de la víctima o victimas
*
Name of Bully/Bullies
Nombre del Acosador/ Bulleador (es)
*
Name of any bystanders/witnesses who may have witnessed the event.
Nombre de testigos que pudieron haber visto el evento.
Not required
Where did the incident happen?
¿En Donde pasó?
*
Include specific details about the location (room number, hallway area, etc.)
Incluya detalles específicos como el salón, número,  nombre del pasillo, etc
When did this incident happen?
¿Cuándo pasó este incidente?
*
Include specific details including a date and time (between classes, at the morning bus stop, etc.)
Incluya detalles específicos como  entre clases,  en que clase, en la mañana, en la parada del camión, etc.
Describe the incident with as much detail as possible.
Describe el evento con mucho detalle.
*
If you would like to be contacted, please type your name here.
Si quiere ser contactado, escriba su nombre aquí.
Not Required
No es obligatorio.
I hereby confirm that I have truthfully reported this incident and that my report contains no false allegations or information.
Confirmo que he reportado la verdad y que mi reporte no tiene datos falsos.
*
Required
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