Arcanum Elementary Bullying/Harassment Reporting Form
Reporting bullying or harassing behavior is the first step toward making our school a safe place for everyone.  Please report bullying if you experience or witness it in school, on the bus, or at school events.  

Use the following form to report bullying.  Fill it out online and it will be submitted directly to the guidance office.  Reports are held in the strictest of confidence.

Thank you for taking responsibility for helping to keep our school safe for everyone!  If you are reporting this incident as a bystander, we will protect your identity.  If you are a victim, we want to help.  Please let us.
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Your Name
Date(s) of Incident(s) *
When did the incident happen? If it occurred on more than one date, please try to be as specific as possible.
Time of Incident
What time did the incident happen?
Where did the incident take place? *
Name of the Bully(ies) *
Who is doing the bullying and/or harassing?
Name of the victim(s) *
Who is being bullied, harassed, or "picked on"?
Type of Bullying *
Who is witnessing, watching the incident, and/or standing by doing nothing to stop it?
Name of the bystander(s) *
Who is witnessing, watching the incident, and/or standing by doing nothing to stop it?
Description of the Incident *
Describe what happened. BE SPECIFIC. How was/were the victim(s) bullied/harassed?
Additional Information
Please give any additional information that you think would be helpful.
Contact Person
Please list a person that could be contacted if additional information is needed.
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