NCUJHS Bullying Report

Your name (or write ANONYMOUS): _______________________

The people involved: __________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

The date and time the bullying occurred: ____________________________________________

Where the bullying occurred: _____________________________________________________

Describe what you witnessed on the lines below. Be specific.

____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Place the completed form in the bully box in the guidance office.

Great Job! You are doing your part to stop bullying at NCUJHS.