Maryetta PS Bullying Reporting System
If you have witnessed a bullying incident or have been bullied while on campus or online, we would like to know. Please provide as detailed information as possible in the fields below. We thank you for notifying us of the incident and will take the appropriate action. NOTE: If you feel you or someone is in immediate danger, please call 911.
What is your name? You can choose to remain anonymous if you prefer.
First Name
Last Name
Are you a student? If so, what grade are you in?
If you are not a student, what is your affiliation with the school district?
When did the bullying incident occur?
*
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Month
-
Day
Year
Date
What time did the incident occur?
*
1
2
3
4
5
6
7
8
9
10
11
12
:
Hour
00
10
20
30
40
50
Minutes
AM
PM
AM/PM Option
Where did the incident occur?
*
Have you already reported this incident to an adult? If so, to whom did you report it?
Back
Next
What is the name and grade of the person being bullied?
*
What is the name and grade of the bully? If unknown, please provide a description of the individual.
*
What happened during the incident?
*
Teasing
Physical violence
Intimidation
Property destruction
Social exclusion
Sexual harassment
Religious harassment
Racial harassment
Theft
Spreading false rumors
Threats
Public humiliation
Stalking
Please provide as much information as possible regarding what occurred during the incident, including who was involved and if there were any witnesses.
*
Were there any specific threats made during the incident? If so, please provide details.
*
Do you have any evidence of the bullying (e.g. texts, photos, video, letters, etc.)? Please upload those here.
Browse Files
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Do you want us to contact you about this incident? If so, please provide your phone number.
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