Bullying & Harassment Reporting
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Have you reported this incident to anyone in authority?
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Yes
No
If you answered "yes", who did you tell?
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Name of person you believe is being bullied or harassed.
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First and last name if known)
Which school?
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Belmont Elementary
Clear Creek Elementary
Horizon Elementary
Mize Elementary
Prairie Ridge Elementary
Riverview Elementary
Starside Elementary
Lexington Trails Middle School
Mill Creek Middle School
Monticello Trails Middle School
De Soto High School
Mill Valley High School
Where, exactly, did the bullying take place? Be specific as possible regarding the incident(s).
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What happened?
Check all that apply
Physical: hitting, kicking, or other physical aggression
Verbal: teasing, name-calling, put-downs, or other behavior that would hurt others' feelings or make them feel bad
Exclusion: starting rumors, telling others not to be friends with someone, or other actions that would cause someone to be without friends
Cyber bullying: using a computer, mobile phone or other electronic device to engage in any previously mentioned bullying
Other, please specify below
Check all that apply
Details for "Other"
Name of the alleged bully.
Please describe the incident.
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Date of the incident
Must contain a date in M/D/YYYY format
Did you witness the event?
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Yes
No
Please list others who may have witnessed the incident.
Your name
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Email Address
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I am....
the person who is being bullied
a student
a school employee
a parent or guardian
a friend
Additional comments
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