Online Bullying Reporting Form

The Commonwealth of Massachusetts passed "An Act Relative To Bullying In Schools" on May 3, 2010. In accordance with this new legislation, the definition of bullying is as follows:

"Bullying" is the repeated use by one or more students of a written, verbal, or electronic expression or a physical act or gesture or any combination thereof, directed at a target that:
(i) causes physical or emotional harm to the target or damage to the target's property;
(ii) places the target in reasonable fear of harm to himself or herself or of damage to his or her property;
(iii) creates a hostile environment at school for the target;
(iv) infringes on the rights of the target at school; or
(v) materially or substantially disrupts the education process or the orderly operation of a school.

In accordance with Section 5D of the Act, below is an electronic form that may be used for the purposes of anonymously reporting bullying or retaliation.

Please note that while all reports of bullying will be investigated, no disciplinary action will be taken against a student solely on the basis of an anonymous report. Any student who knowingly makes a false accusation of bullying or retaliation will be subject to disciplinary action.

Please be sure to give as many details about the incident as possible.

 

Bullying Reporting Form



Reported by:
*School: East    Foster    Plymouth River    South   
Middle School    High School   
*Grade Level of Student Being Bullied: K    1    2    3    4    5   
6    7    8   
9    10    11    12   
*Full Name of Student Being Bullied:
*Grade Level of Aggressor: K    1    2    3    4    5   
6    7    8   
9    10    11    12   
*Full Name of Aggressor:
*When it Happened:
*Where it Happened:
*What Happened:
Contact Information: