Georgia College Early College - Report Bullying
Who was the person being bullied?
First Name
Last Name
What is the grade level of the person being bullying?
7
8
9
10
11
12
Who was the person doing the bullying?
First Name
Last Name
What is the grade level of the bully?
7
8
9
10
11
12
When did the bullying take place?
Did you see the bullying take place or did you hear about it from someone else?
I witnessed the bullying.
I heard about the bullying from someone else.
Did the bullying take place during school or away from school?
During school
Away from school
Both
How was the person being bullied? (ex. physically, Facebook, cell phone messages, etc.)
What was the person being bullied about?
List others that were also involved:
Describe specific details about the incident:
Submit
Should be Empty: