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Report a Bullying Incident
Report a Bullying Incident
Bullying Incident Report
This form requires Javascript to be enabled for submission and authorization.
*
Required
Name (Optional) Nombre (opcional)
First Name, Nombre de pila
Last Name, Apellido
Your relationship to the alleged victim or offender (optional). Su parentesco con la presunta víctima o el presunto agresor (opcional).
Your contact number (optional) Su número de contacto (opcional)
Campus(es)
*
required
Choose the campuses of the alleged victims and bullies.Seleccione los campus de las presuntas víctim
Yoakum High School (9 - 12)
Yoakum Junior High (6 - 8)
Yoakum Intermediate School (3 - 5)
Yoakum Primary School (1 -2)
Yoakum Annex (EE - KG)
Unknown/Desconocido
Choose the campuses of the alleged victims and bullies.Seleccione los campus de las presuntas víctim
Alleged Victim(s) Name and Grade Nombre y grado de la(s) presunta(s) víctima(s).
0 / 1000
Alleged Bully(ies) Name and Grade/Nombre y grado del/de los presunto/s acosador/es
Witnesses/Testigos
Date of Incident/Fecha del incidente
*
required
Must contain a date in MM/DD/YYYY format
Time of the incident/Hora del incidente
*
required
Location of Incident. Please be specific. Lugar del incidente. Por favor, sea específico.
*
required
Did the alleged incident take place on school property? ¿El supuesto incidente tuvo lugar en las instalaciones de la escuela?
*
required
Yes/Sí
No
Did the alleged incident take place during the school day? ¿El supuesto incidente tuvo lugar durante la jornada escolar?
*
required
Yes/Sí
No
Did the alleged incident occur at a school-sponsored activity? ¿El supuesto incidente tuvo lugar durante una actividad patrocinada por la escuela?
*
required
Yes/Sí
No
Please describe the alleged incident. Por favor, describa el supuesto incidente.
*
required
Is this the first incident?
*
required
Yes/Sí
No
Not sure/No estoy seguro
Click Submit to submit your report. By clicking Submit, you affirm that the information is true and correct.
Haz clic en Enviar para enviar tu informe. Al hacer clic en Enviar, confirmas que la información es veraz y correcta.
Submit/Entregar
