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Anonymous Bullying/Threatening Behavior Report
Please fill out the Anonymous Bullying/Threatening Behavior Report below.
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* Indicates required question
Provide your contact information (name, email, etc.) if you would like. (optional)
Your answer
Who are you?
*
Student
Teacher
School Staff Member
Administrator
Board Member
Volunteer
Parent
Other
Required
Please choose the location where the incident happened.
*
Classroom
Hallway
Playground
Cafeteria
Other
Required
What date did this incident happen?
*
MM
/
DD
/
YYYY
What time did this incident happen?
*
Time
:
AM
PM
How many times has this situation happened?
*
Your answer
Have you reported this incident to an adult?
*
Yes
No
Required
Who was bullying, harassing, intimidating or causing harm? (Please include first name, last name, and grade if possible.)
*
Your answer
Describe what happened. Give as much information as you can. Let us know if there were any witnesses.
*
Your answer
If you are not a student at this campus and would like someone to contact you please add your phone number here. (Optional)
Your answer
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