Bullying Incident Report

Are you being bullied, or have you witnessed someone who is?

If you are a student who is being bullied, or if you have witnessed a bullying incident among students, it is important to tell an adult.  You can use this online form to report the incident (anonymously if you prefer).  The information will be sent to the school principal and investigated promptly.

Bullying Incident Report
1)Date of Incident*:


2)Names of those involved*:


3)Location of Incident *:


4)What room, classroom or area did this incident take place?*:


5)Description of Incident*:


6)Optional: Your Name and Contact Information:



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