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CHS Bully Reporting
CHS Bully Reporting
Your Name
Your name is optional. If you wish to remain anonymous, leave this blank.
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Relationship to victim
*
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Please Select
Self
Parent/Guardian
Teacher
Classmate
Other
Who was bullied? (Name and Grade)
You can name the person who was bullied, or just describe him or her; for example, a small sixth grader.
Answer Required
Who did the bullying? (Name and Grade)
*
Answer Required
When did the bullying happen?
*
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Where did the bullying 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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