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) Upload screen shots or photos: Add More DISCLAIMER: You may not upload sexually explicit photos. Please report any sexually explicit images directly to law enforcement or to your school administrators. 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 Enter your phone number if you wish to be contacted by a school administrator: * 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. Email me a copy of this report « Previous Report Now » Next » Click the “Add More Info” button to upload screenshots or see our additional reporting options.
