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Reporting A Bully Form

Please complete the form below to the best of your ability.  All questions with an * asterik must be answered before the submission in order to be able to address the problem; the victim and the bully must be identified.

This information is addressed by the administrators of the district and is strictly confidential.

Please indicate where the incident took place.*
Do you know the main bully?*
Do you know the second bully?
Do you know the victim?*
Gender of the bully?*
Gender of the second bully?
Gender of the victim?*
Grade of the bully?*
Grade of second bully?
Grade of the victim?*
Have you told any teacher, school administrator, parent or other adult about this incident?*

The reporters personal information is OPTIONAL and appreciated.  

Your grade?
You may upload any files related to the incident.
or drag it here.
Confirmation Email
Please verify you are not a robot:

The Orange Grove I.S.D. and its Career and Technology Education Program do not discriminate on the basis of sex, disability, race, color, or national origin in its educational programs, activities, or employment as required by Title IX, Section 504 and Title VI.