Bully Incident Report
IF YOU ARE IN IMMEDIATE DANGER, CALL 911

Houghton-Kearney is committed to providing a safe, comfortable learning environment for all students.  Bullying incidents can be reported directly to a staff member at your school.  This online form may also be used by Houghton-Kearney students to report being bullied or by someone witnessing a student being bullied.  

Once submitted, the investigation process will begin within one (1) working day.  Keep in mind, this process can only be as thorough as the information provided.  Thank you for your assistance in making Houghton-Kearney a safe place for all.
Sign in to Google to save your progress. Learn more
What type of incident is this? *
Location where the incident occurred *
Person reporting incident *
Person reporting incident contact #
Person reporting incident contact email
Which best describes you? *
Name(s) of alleged offenders *
Please describe the bullying incident.  Try to include as many details as possible. *
Name(s) of any witnesses
Check all bullying types that apply to this incident *
Required
Thank you for your help.
By completing this form, you are verifying that your statements are true and accurate to the best of your knowledge.  
If you have trouble completing this form and would like to speak to someone, contact 559-276-5235.
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Central Unified School District. Report Abuse