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Required
Report A Bully
Make sure that what you report is accurate and simply not heresay. Heresay is a rumor, often gossip that is passed around by word of mouth. To be accurate, you must have witnessed the event(s) or have been told about them either from the actual person being bullied or from the bully.
I have reported this event to my school.*
Yes
No
WHO was bullied?
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required
Please give the first name, last name, and grade level.
Please describe what happened.
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required
Please include where and when the incident occurred.
Who was DOING the bullying?
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required
Please include first name, last name, and grade level.
Your name (optional):
I am a*
Student
School employee
Parent/guardian
Person being bullied
Community member
Friend
Other, please specify
Other, please specify:
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required
Type of bullying (check all that apply)*
Physical bullying - Injury to the person or his/her belongings is characteristic of this method. The bully may have punched, kicked, shoved, or spit on the victim.
Cyber bullying - Take place in cyberspace. This type of bullying involves various forms or victim harassment, including posting pictures of the victim on websites against his/her wishes and sending pictures through cell phone texting.
Emotional bullying - To exclude the victim from social situations and cause mental pain while leaving the victim feeling alone.
Verbal bullying - The person will say put-downs and rude things directly to the victim, usually in front of his/her friends.
Other, please specify
Other, please specify:
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required
Were you there when the incident occurred?*
Yes
No
List other students or adults who witnessed the incident: