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Student Information - Report a Bully


Report-a-Bully
"A Safe Way to Report a Bully"

Please fill in all the information you can to help us stop the bully!
Which School do you want the report to be sent to?

please select a campus


Should I Report?

Bully's Name:
  
Main Bully's First Name
Main Bully's Last Name
Please try to give us a name or nickname. Don't worry about the spelling, spell it like it sounds.
Second Bully's Name:
  
Second Bully's First Name
Second Bully's Last Name
 If there was a second Bully or a person helping the Bully put their name on this line.
Victim's Name:
Victim's First Name
  
Victim's Last Name
You can use any name including nicknames.  Don't worry about the spelling, spell it like it sounds. If it was you then put your name.
Date/Time of Incident:
Date
(Example: 03/25/2004)
Time
(Example: 1:30 pm)
Do the best you can to remember the date and time.  You can click HERE for a calendar.
Do you know these people?:
 Tell Us Your Relationship with These People
Main Bully
Second Bully
Victim
Where did the incident happen?

Please give us the names of witnesses or bystanders who might also have seen this happen besides you.
Description
Tell us what the Bully did to the Victim.

Other Information That Might Help Us
 
Race:
 
Bully
 
Second Bully
 
Victim
Gender:
 
Bully
 
Second Bully
 
Victim
Grade:
 
Bully
 
Second Bully
 
Victim
Your Information - Optional But Appreciated
WE PROMISE TO PROTECT YOU
Your Name:
 
First Name
 
Last Name
Contact Info:
 
Phone Number
 
Email Address
Grade and ID:
 
Your Grade
 
Your ID Number

 

 

 

Students

 

Parents and Teachers

 

 
© APISD 2003-2004
244 W. Harrison
Aransas Pass, TX 78336
Phone:361-758-3466 | FAX:361-758-2962