Report Bullying Person reporting bulying First Last Please provide your name. I wish to remain anonymous. What is your relationship to the person being bullied?*I am the parent / guardian of person being bulliedI am a classmate, friend, or sibling of the person being bulliedI am the parent or guardian of a peer of the person being bulliedI am the person being bulliedAlleged Bully* First Last Individual Bullied* First Last Describe incident(s)*Where did the incident(s) happen?*Type of bullying* Verbal Physical Social/Relational Electronic/Written When did this happen?* Were there witnesses?NoYesWho witnessed the bullying?How long has this been happening?Is the event repeating?YesNoWhich school or facility is this related to?*High SchoolMiddle SchoolEastwood ElementaryParker ElementaryRiley ElementarySunndyside ElementaryWestwoodWilbur WrightOtherCAPTCHA