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 bullied I am a classmate, friend, or sibling of the person being bullied I am the parent or guardian of a peer of the person being bullied I am the person being bullied Alleged 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?* MM slash DD slash YYYY Were there witnesses? No Yes Who witnessed the bullying?How long has this been happening?Is the event repeating? Yes No Which school or facility is this related to?*High SchoolMiddle SchoolEastwood ElementaryParker ElementaryRiley ElementarySunndyside ElementaryWestwoodWilbur WrightOtherCAPTCHA