Gustine ISD Bullying Reporting Form
This form is to be used to report potential incidents of bullying.  The purpose of this form is to alert Gustine ISD Administrators of possible inappropriate behavior so they can conduct a thorough investigation.  Providing more detailed information will lead to a more thorough the investigation.  
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Date *
MM
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DD
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YYYY
Person making report:  (This is optional, however by giving us your name it will make a thorough investigation easier.)
I am a: *
Day Time Phone Number (optional)
Address (optional)
Email Address (optional)
Person or Persons That Are The Target of Inappropriate Behavior                                           (Please provide first and last names.) *
Person or Persons That Are Behaving Inappropriately                                                         (Please provide first and last names.)
Date of Incident *
MM
/
DD
/
YYYY
Time of Incident *
Time
:
Location Where Incident Occurred (Be as specific as possible.) *
Type of Harassment *
Witnesses (List people who saw or heard the incident or that have relevant information about the incident.  Please tell us if the witness is a parent, staff member, student or community member.) *
Description of Incident *
Describe the incident in detail, including the name of the person or persons involved, what was said and done, and specific words used. *
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