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Report Bullying Anonymously

Purpose: To give anyone the ability to anonymously report any bullying. If you are the victim of bullying you may use this form to report an incident. *Require information/*Información requerida

Victim Information / Informacíon Sobre La Víctima

School/Site | Escuela/Lugar de trabajo*

Answer Required

Victim(s) | Nombre(s) de la(s) victima(s):*

Answer Required

Reporting Information / Datos De La Persona Que Realiza El Informe

Person Reporting | Nombre/Título:

(optional/opcional)

Answer Required

Phone Number | Teléfono

(optional/opcional)

Answer Required

Incident Information / Detalles Del Incidente

Accused Bully Name(s) OR a description of bully (if name is unknown) Nombre del acosador que fue acusado o su descripción (si su nombre se desconoce)*

Answer Required

Location of incident | Lugar del incidente*

Answer Required

Date and time of incident | Fecha y hora del incidente*

Answer Required

Describe what happened in as much detail as possible. | Describa lo que ocurrió en tantos detalles como sea posible.*

Answer Required