Items denoted with a red asterisk * are required.
Who is the bully?
Who is the victim?
Please describe the incident. Try to include the who, what, when, where, and why?
Does the bully act this way with other students or was this an isolated incident?
You can either choose to remain anonymous or submit your name confidentially so Mr. Borden can discreetly find time to meet with you to discuss it further. Please submit your name or type "anonymous."