Secret Bully Report
Secret Bully Report

Have you been bullied? Have you seen someone be bullied? Don't be afraid to let us know! Fill out this Online Secret Bully Report to give us the 411 on bullying at our school. Don't forget that even though you need to fill out your name no one will find out who gave us the information.

Your Name:

Your Teacher's Name:

Date of incident:

Bully(s) Victim(s)

Select from the list below what is happening to you or what you have seen happen to someone else.

Hurtful things are being said to me or written about me.

Someone has touched or pushed me and I feel uncomfortable.

Someone is teasing me.

A student or students are bothering me with body language or words.

Describe the incident below in your own words.

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