Reporting an Online Concern
Parents and or students can use this form to raise a concern about an online issue.
Please note that if you do not provide contact details to we may be limited in our ability to effectively manage your concern.
Compulsory fields are marked with an (*). You do not have to answer questions that are not compulsory. These compulsory questions are necessary for us to manage your report. If you do not provide an answer to these questions, we may not be able to accept your report.
This will be directed to the ICT Co-Ordinator at the school who will be able to investigate the issue and use the schools processes to help resolve.
Sign in to Google
to save your progress.
Are you submitting this complaint for yourself or for a child you know (including your own child)?
I am a student at the school
On behalf of a student at the school
What is your name?
What are the names of student/s involved in the report/concern?
Where is the cyberbullying happening? Is it happening on a SOCIAL MEDIA SERVICE?
NOT A SOCIAL MEDIA SERVICE ISSUE
Where is the cyberbullying happening? Is it happening through ONLINE MESSAGING?
NOT AN ONLINE MESSAGING ISSUE
Online chat service
Instant messaging service
Where is the cyberbullying happening? Is it happening through ONLINE GAMING?
NOT AN ONLINE GAMINE ISSUE
If yes, which game?
Where is the cyberbullying happening? Is it happening through DIRECT MESSAGING?
NOT A DIRECT MESSAGING ISSUE
Phone chat service
Where is the cyberbullying happening? Is it happening through EMAIL?
NOT AN EMAIL ISSUE
What is happening? (Try to tell us in as much detail what is going on. The more you tell us, the more we can help. Really useful information includes: - what is happening, and when did it happen; - who is doing the cyberbullying; - and how the cyberbullying is happening.
What would you like us to do?
Help get the cyberbullying material removed from the service it is on
Work with the school to help stop the cyberbullying
If we require further information, can we call you to discuss your complaint further?
If yes, please provide best contact number.
A copy of your responses will be emailed to the address you provided.
Never submit passwords through Google Forms.
This form was created inside of Kunyung Primary School.