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Brown Bullying Report
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Email
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Your email
Student at Brown Elementary School
During this incident I was a:
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**VICTIM**
Witness
Child report multiple incidents of children causing physical harm by hitting him and reporting it to the teachers, however, the behavior continues. Today, my son reported two students surrounding him and repeatedly told him they wish he would die.
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Your answer
Untitled Title
What grade are you in? (optional)
Kindergarten
First Grade
Second Grade
***IS IN Third Grade*****
Fourth Grade
Fifth grade
Not a current student
Parent
Staff Member
Other:
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Jacob, Clarice, and Tim all in Ms. Addudell and Thompson classes - BULLYING HIM ON AN ONGOING BASIS.
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Your answer
Where did this incident take place?
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Classroom
Hallway
Bus
Cafeteria
Off School Property
***RECESS***
Other:
Required
Were there witnesses to this incident?
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Yes
No
***NOT SURE*** did not report it to the teacher as he felt nothing would be done.
Other:
What are the names of the witnesses? (optional)
Your answer
Please rate the severity of this incident from your perspective, 1 being minor incident but unacceptable to 5 being major incident, could result in retaliation or violence.
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Minor, but unacceptable
0
1
2
3
4
5
Major incident **RATED AS 5 MAJOR**
Please describe the frequency with which this type of incident occurs.
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1
2
3
4
5
***Every day- Most Days***
this makes him angry and sad. He wants them to stop and he wants to know if/when reporting something will be done about it.
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Your answer
Did this or other incidents make you feel like harming yourself or others?
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Yes
No
***Maybe*** WE MET WITH THE COUNSELOR YESTERDAY FOR THIS REASON.
Would you like to speak with a counselor? If yes, please add your name below.
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Yes
No
Your answer
I RATE THIS INCIDENT A 5/5 AS A MAJOR BULLYING INCIDENT THAT MUST BE ADDRESSED ASAP.
Your answer
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