Bullying Report Form - Edgewood Schools

Person Reporting Bullying*

First Last

When did the bullying happen?*

Who do you think was bullied?*

First Last

Where does this person attend school?*

Who is this person's teacher?

First Last

What grade?*

Who do you think was bullying?*

First Last

What grade?*

Type of Bullying*

(check all that apply)

Where did the bullying happen?

(check all that apply)

Is this the first time that this has happened?*

Who has been told about the bullying or saw what happened?*

(check all that apply)

Have you filed a Student Bullying Report before?*

Any other information that you would like to share?