Editing previous response:

Please fix the highlighted areas below before submitting.

CHS Bully Reporting

Your Name

Your name is optional. If you wish to remain anonymous, leave this blank.

Answer required for "Your Name"

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 for "Who was bullied? (Name and Grade)"

Who did the bullying? (Name and Grade)*

Answer required for "Who did the bullying? (Name and Grade)"

When did the bullying happen?*

Answer required for "When did the bullying happen?"

Where did the bullying happen?*

Answer required for "Where did the bullying happen?"

Type of Bullying*

Answer required for "Type of Bullying"

Verbal

Non-verbal

Physical

Cyber-bullying

Other:

Briefly describe the incident*

Answer required for "Briefly describe the incident"

Any other information that you would like to share

Answer required for "Any other information that you would like to share"