Anonymous Bullying Report Form
If you have information regarding bullying towards yourself or others and would like to report this information anonymously, please fill out this form with as much detail as possible. For the purpose of this form, bullying encompasses bullying, harassment, and discrimination, including cyber incidents. This report will be followed up on within two school days. If you fear there is immediate physical danger, please contact the office (949-234-5360) or the police right away.
Victim's Name *
First and Last (if known)
Your answer
Victim's Grade
Accused Bully's Name *
First and Last (if known)
Your answer
Where did this incident occur? *
ex. in front of the lunch lines
Your answer
When did this incident occur? *
Please be very specific with date and time.
Your answer
Please provide specific details of the what occurred. *
Your answer
Does this happen frequently? *
Required
Please list any witnesses that saw what happened. *
Include first name, last name, grade level if known. If there are none, please state N/A.
Your answer
List any other information that might be pertinent you have not already stated.
Your answer
I give permission for an administrator to talk to me about this incident if more information is needed for the investigation. *
Your answer
Submit
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