Español Hus Hmoob For more information about bullying-prevention at MMSD, please visit our site. Download a print-version of the form Person(s) engaged in the bullying behavior. * Please include full name(s), ages and school, if known. Date of Incident * Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 Year Year20172018201920202021 Location of incident * Select Allis Badger Rock Blackhawk Capitol Chavez Cherokee Crestwood East High School Elvehjem Emerson Falk Franklin Glendale Gompers Hamilton Hawthorne Huegel Jefferson Kennedy La Follette Lake View Lapham Leopold Lincoln Lindbergh Lowell Marquette Memorial Mendota Midvale Muir Nuestro Mundo O'Keeffe Olson Orchard Ridge Randall Sandburg Schenk Sennett Shabazz Sherman Shorewood Spring Harbor Stephens Thoreau Toki Van Hise West High School Whitehorse Wright Check the statement(s) that best describe what happened (choose all that apply). * Touch, including hitting or pushing Get another person to hurt the student Teasing, name-calling, make mean/harmful remarks/gestures, or threaten person Ignoring or rejecting the student Intimidating words or actions Spreading harmful rumors or gossip Cyber bullying (e.g. social media including Facebook, Twitter, Vine, Snapchat, Instagram, etc.) Electronic communications (e.g. e-mail, text, sexting, etc.) Damage/steal personal property Other * If "other" is chosen, please describe: What happened? * Please describe the incident. Where did it happen? * Did anyone see anything? If yes, who? * Please list names of any witnesses who might have seen something happening. Why do you think this happened? * Name (optional) If you feel comfortable, please include your name. CAPTCHAThis question is for testing whether or not you are a human visitor and to prevent automated spam submissions.