eSmart - Report a Cyber Bullying Incident

STUDENT ALLEGEDLY BULLIED
Name: *
Grade: *
Date of Incident: *
Location of Incident:
Nature of Incident: *
ALLEGED PERPETRATOR(s)
Name(s): *
Grade(s): *
Witnesses to the Incident:
Parent/Guardian Name: *
Parent/Guardian Contact Number: *
Parent/Guardian Email: *
 

* = required field

Please remember, bullying is when someone or a group of people who have more power at the time deliberately upset or hurt another person on more than one occasion. Bullying is not a situation where there is mutual conflict, social rejection or dislike or single episodes of nastiness, meanness or one off acts of aggression or intimidation.