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Oceana High School Bullying Report Form
Jefferson Union High School District promotes a secure and positive school climate free from any type of bullying behavior. Anyone who witnesses bullying is asked to report the incident to the school administration immediately.
Falsely accusing one another of bullying is prohibited. Disciplinary action will be taken.
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* Indicates required question
When did the bullying take place?
*
MM
/
DD
/
YYYY
Where did the incident occur?
*
Choose
In a text message
In a voicemail
In an email
In an instant message
In class
In the hallway
in the cafeteria
In the gym
In the locker room
In the parking lot
Before school program (zero period)
After school program
Off the school grounds
Other
Who was bullying or causing harm? Include first name and last name, if known
*
Your answer
Who was being bullied? Include first name and last name, if known
*
Your answer
Were there any witnesses? Include first name and last name, if known
*
Your answer
Describe the incident using as much detail as possible
*
Your answer
What kind of harm was done? Note, you can pick more than one.
*
physical (examples are pushing, hitting, tripping, kicking, etc.)
emotional (examples are hurt feelings, fear, intimidation, etc.)
property (examples are vandalism, theft, destruction of property, etc.)
reputation (examples are spreading rumors, creating fake social media, etc.)
Other:
Required
What is your name? (optional) Anonymous reports are accepted! Note that anonymous reports must provide sufficient evidence to justify the commencement of an investigation. Formal disciplinary action may not be based solely on an anonymous complaint.
Your answer
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