Anonymous Bullying Complaint Form

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"Bullying is unwanted, aggressive behavior among school aged children that involves a real or perceived power imbalance. The behavior is repeated, or has the potential to be repeated, over time. Both kids who are bullied and who bully others may have serious, lasting problems.

In order to be considered bullying, the behavior must be aggressive and include:

An Imbalance of Power: Kids who bully use their power—such as physical strength, access to embarrassing information, or popularity—to control or harm others. Power imbalances can change over time and in different situations, even if they involve the same people.
Repetition: Bullying behaviors happen more than once or have the potential to happen more than once."

stopbullying.gov

Grade band *

K-2

3-5

6-8

9-12

None

Please describe the incident. The more details you can provide, the better equipped the school will be to address the issue. Please include the date of the incident, where the incident took place and if there were any witnesses to the bullying incident. *

To your knowledge, have any threats of suicide been made? *

Yes

I don't know

To your knowledge, have any threats of violence been made? *

Yes

I don't know

If you wish to be contacted to discuss this incident, please enter your information below. You do not have to provide this information.

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