Report Bullying

"*" indicates required fields

Campus*

Your Name:

Leaving your name makes this report identifiable. We will still treat your information as confidential but the school counselor or administrator may connect with you regarding this report. If you do not leave your name, we will observe and investigate to the best of our ability. If you feel like this needs a more urgent response or intervention please reach out to the school counselor, principal or Head of School.

Individuals involved?*

Please describe what happened:*

Where did the incident occur?*

Please list the names of any witnesses that saw the incident take place

How often has this situation occurred?

How have you responded to the situation?

Who have you spoken to about the incident?

Who do you want to be notified of this incident?*

What would you like the response to be?*

I just want someone to be aware.

I want an adult to talk to the individual(s) causing the situation

I want an adult to help solve the problem.