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Bully Reporting

Your Name

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Who was the victim in the situation? (Name and Grade)*

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Who were the other student(s) involved ? (Name and Grade)*

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When did the incident happen?*

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Where did the incident 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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