Quick Links
Skip to main contentSkip to navigation

Broken Arrow Public Schools

Working...

Ajax Loading Image

 

Report & Stop Bullying

Please call 911 if life is in danger.

Please complete the entire report responding to those questions that you feel comfortable answering and are able to accurately report.


Please use this feature to attach any additional documentation needed for the report.

Reporting Person Information *optional

Student     Parent     Community Member

Name

Telephone   Email

Incident Details

School Site  *required

Date  Time

Name of Student Affected  Grade

Name and grade level of student(s) initiating bullying. (if you don't know the student's name(s) describe him/her)

 

Description of bullying incident(s): where, when, & what happened.

 

Name(s)of any witnesses and their grade level.

 

Have you or the victim missed any school or made any changes to your daily routine as a result of the incident(s)? (yes, no, unsure)

Type of Alleged Harassment

Racial     Sexual     Religious     Other

Is this a repeat offense? Yes      No

Has a complaint relevant to this issue been filed before? Yes      No

Check all spaces below that apply. Inappropriate behaviors include:

Gesture, written, or verbal expression

Electronic communication - phone, e-mail, photos, social media, tweets, etc.

Physical Act - fight or injury

Damaged or stolen property

Once you have clicked the submit tab, your report will be submitted to the site principal. Reports filed with contact information will receive a response within a reasonable amount of time to allow administrators to investigate the report.

Thank you for assisting our district in our joint effort to stop and prevent bullying.