SPSD Bullying and Anonymous Safety Report Form
The South Panola School District Bullying and Anonymous Safety Report Form is for reporting sensitive information to school officials. This may include violence towards or from a student, employee or teacher, drug use, sexual harassment, bullying, threats, weapons, emergency assistance, gang activity, or any inappropriate behavior.

Use the following form to report bullying, which includes incidents of cyberbullying, and any other safety concerns. Complete the form online and it will be submitted directly to administration.

Whether you are a witness or target in this case, we want to thank you for helping us maintain a positive and safe school environment for all of our students.

Name: *
Your answer
Today's Date: *
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Please let us know if you are a student, parent, community member, administrator, et cetera: *
Your answer
Phone Number: *
Your answer
Name of person(s) endangering student safety/exhibiting misconduct or inappropriate behavior (if possible): *
Your answer
Name of person(s) being harassed/bullied (if possible): *
Your answer
Describe the incident(s) and how long it has taken place? Be as specific as possible. *
Your answer
Did anybody witness the incident? If so, who? *
Your answer
Date/time event occurred: *
Your answer
Which school, if possible, did this event take place? If the event took place outside of school grounds, please specify. (Example: Football field, school bus, online, et cetera.) *
Your answer
Have any school staff been notified about this incident? If so, who and when were they notified? *
Your answer
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