Bullying Report

I am concerned about: (Student's first and last name)

He/She attends which School in Lancaster ISD?

He/She is in which grade?

I am concerned about this student because Question is mandatory

I think he/she is a victim of bullying and/or cyber-bullying.

I think he/she is bullying/cyber-bullying others.

If possible, please tell us who was bullying, harassing, intimidating, or causing harm?

Where did this incident occur?

When did this incident occur?

(MM/DD/YYYY)

How many times has this situation occurred?

Have you reported this incident to an adult? If so, whom?

Please use this space to add any details and describe what happened. Please give as much information as you can, including any witnesses.