This form is for use by employees, substitutes, and volunteers to report incidents of student bullying.

This form must be completed and submitted within two school days of witnessing or acquiring firsthand knowledge of any bullying incident involving a student.

Employees, substitutes, and volunteers who did not witness or have firsthand knowledge of an incident of bullying but receive a report from someone who did may also use this form.

Bullying frequently involves repeated behavior. If you have witnessed or have knowledge of more than one incident, please provide information on all incidents. Please feel free to use multiple forms.