This form is to be used when suspicious activity or bullying is occurring. Please use this form in a responsible manner. Please provide as much detail as possible to help us deal with the problem effectively and in a timely manner.
Name(s) of person(s) committing suspicious activity or bullying.(*)
Please enter the name of the person(s) committing suspicious activity/bully.
Name(s) of victim(s).
Please enter the name of the person being bullied.
Your Name (optional)
I am a
Please choose one or more of the following.
Type of Bullying
(Select all that apply)
Please select the type of bullying.
Type of suspicious activity
Enter details to above selection.
Description of events
(Please be specific - use exact wording, names, dates, location and time, etc.):(*)
Please describe the event.
Did you witness the suspicious activity or bullying?(*)
Please specify yes or no.
Please list other students/staff who may have witnessed the suspicious activity or bully described above:
The administrators will investigate the report and take appropriate actions to deal with the situation. Since much of what we do needs to remain confidential, you may not know of the steps we take to stop the activity. If the activity does not stop, we need to take additional steps. Please let us know if the activity continues.