What Happened? Please tell us about the incident (fields with * are required). Who are you reporting? (Who did this negative behavior?) * Describe what happened and who was involved. * What type of incident was it? * --- Select --- Verbal Bullying Social or Emotional Bullying Physical Bullying Cyberbullying Harassment Intimidation Assault Disrespecting Authority Harsh Teasing Other When did it happen? Where did it happen? * --- Select--- Classroom Hallway Lunch Room Bus Computer Room Auditorium Library Gymnasium Bathrooms Online Outside Parking Lot Sports Field Other My role in this incident: * --- Select--- I was bullied I was cyberbullied I was being a bully I saw it with my own eyes I heard about it I was a verbal upstander Other Your Information Name of Your School * Select School * I am a* --- Select --- Student Parent Relative Teacher School Staff Community Member Your First and Last Name I don’t want to leave my name. Additional Details (Optional) Would you like to add any screenshots, photos, or additional details? Upload screen shots or photos Add More How long has this been happening? --- Select--- First Time Second Time Every Few Weeks Every Day Multiple Times Per Day How many times have you reported this? --- Select--- This is My First Time Second Time Third Time Many Times Would you like someone to contact you? --- Select --- No Thanks Yes, School Counselor Yes, School Principal Enter your phone or email if you wish to be contacted: * I promise this is not a false report. I am who I say I am. I know that my device ID can be tracked when reporting. « Previous Report Now » Next » Click the “Add More Info” button to upload screenshots or see our additional reporting options.
