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Spurger ISD Bullying Report
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* Indicates required question
Person Filing Report
(Note: Reports may be filed anonymously)
Your answer
Additional contact information
Phone or email (Note: Reports may be filed anonymously)
Your answer
Who is being bullied?
*
Your answer
Who is the bully?
*
Your answer
Where is the bullying taking place?
*
school bus
common area/playground
hallway
online, texting, or telephone
restroom
classroom/library
cafeteria
gym/locker room
Other:
Required
Date and Time of most recent incident:
*
MM
/
DD
/
YYYY
Time
:
AM
PM
Describe what happened:
*
Your answer
Witnesses (List people who saw or have information about the incident(s))
*
Please list name, and indicate whether they are students, staff, or parent.
Your answer
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