Formal Bullying Incident Report Form
The following form can be used to make a formal report of bullying to your school's principal. Make a copy for yourself and carbon copy if needed.
Bullying
Incident Report Form
Date:
Grade:
Name of Person Filing Report:
Relationship to Victim:
Date and Approximate Time of Incident:
When did you learn of this incident?
Description of Incident
(include names of those involved and specific details: what, where, when, how, etc.):
List the names of any witnesses to this incident:
Signature of Person Filing Report:
Please return this form to the Building Principal or Designee
CC: