JCCHS Bullying Incident Report
Bullying, harassment, or intimidation are serious acts and will not be tolerated at John Carroll. This is a form to report alleged bullying, harassment, or intimidation that occurred on school property; at a school-sponsored activity or an event off school property; or on the way to and/or from school, in the current school year. If you wish to report an incident of alleged bullying, harassment, or intimidation, please complete this form with as much detail as possible. Contact the school for additional information or assistance at any time.
Name: *
Your answer
Telephone:
Your answer
E-mail: *
Your answer
Name of student victim:
Your answer
Name(s) of alleged offender(s) (if known):
Your answer
Where did the incident occur? (Choose all that apply.)
Please describe what happened (Choose all that apply.)
What did the alleged offender(s) say or do?
Your answer
Do you have any information to share about why the bullying, harassment or intimidation occurred?
Your answer
Is there any additional information you would like to provide?
Your answer
Submit
Never submit passwords through Google Forms.
This form was created inside of John Carroll Catholic High School. Report Abuse - Terms of Service