Naperville 203 Report of Bullying

To be completed by the bullying target, witness, or person with information about an incident of bullying.

In the event of an emergency or a situation that may escalate into an emergency, please contact 911 immediately. For all other matters, our commitment is to respond to your submission within 24 hours, provided it is received during our regular operating hours: Monday - Friday, 7:30 a.m. - 4:00 p.m.

Please note the following:

  • Submissions received on Fridays after 4:00 p.m. through Monday at 7:29 a.m. will be addressed within 24 hours from the opening of the next business day at 7:30 a.m.

  • If a submission is made when the district is closed, including holidays and weekends, you can expect a response within 24 hours from the opening at 7:30 a.m. of the next business day.

Should the matter be urgent or potentially lead to an emergency, please do not hesitate to contact 911.


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Role *
Full Name *
Your full name will be shared with building and district administrators to support a response.
Do you prefer to remain anonymous?
*
What is the Naperville 203 school(s) connected to this incident? *
Required
Are you the target of the bullying that you are reporting?
*
Date of Incident *
If the exact date is unknown, please provide an approximate date.
MM
/
DD
/
YYYY
Time of Incident *
If the exact time is unknown, please provide an approximate time.
Time
:
Targets of Bullying
The person(s) who was harmed, injured, or impacted by the actions and behavior of the aggressor.
List all students being reported as targets of bullying
List all staff being reported as targets of bullying
List all other individuals being reported as targets of bullying
Aggressors Engaged in Bullying
The person(s) who started and/or engaged in the harmful behavior. The person(s) who did something wrong or caused the harm.
List all students being reported as aggressors engaged in bullying
List all staff being reported as aggressors engaged in bullying
List all other individuals being reported as aggressors engaged in bullying
Witnesses of the Bullying
The person(s) who watched, viewed, or experienced the incident between the aggressor and/or victim. A person who experienced any facet of the bullying event.
List all students who witnessed the bullying
List all staff who witnessed the bullying
List all other individuals who witnessed the bullying
Was the incident based on any of these characteristics? (Check all that apply.)
*
Required
The individual(s) was targeted for bullying in the following way(s) (Check all that apply.)
*
Required
The individual(s) was targeted for bullying in the following place(s) (Check all that apply.)
*
Required
Please tell us about the incident in your own words. Use as much detail as possible - what time did the incident(s) take place, who witnessed it, what was said, what types of interactions occurred (e.g., physical, written, social, electronic, etc.)
*
Submit
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