Report A Bully
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Your Name
Your answer
I am a
Where did the incident occur?
When did it happen?
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How many times has this situation happened?
Have you reported this incident to an adult?
Who was bullying, harassing, intimidating or causing harm? (Include first name, last name and grade if known)
Your answer
Describe what happened. Give as much information as you can. Let us know if there were any witnesses.
Your answer
If you would like someone to contact you, please add your email or phone number here. (Optional)
Your answer
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