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Bully Reporting
Your Name
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Relationship to victim
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Please Select
Self
Parent/Guardian
Teacher
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Other
Who was bullied? (Name and Grade)
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Who did the bullying? (Name and Grade)
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When did the bullying happen?
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Where did the bullying happen?
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Type of Bullying
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Verbal
Non-verbal
Physical
Cyber-bullying
Other:
Briefly describe the incident
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Any other information that you would like to share
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