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LITTLEFIELD
ELEMENTARY SCHOOL

At Littlefield ISD, we take any behavior or action that affects the students in a negative way very seriously. Bullying of staff or students will not be tolerated.

Please complete this form to the best of your knowledge so we can assist you.

The information will be kept confidential with your campus administrators and/or superintendent.

Please Fill Out The Elementary Bully Report Form Below

Date of Incident:

Date of Report:

Who was the bully?

What grade or class is the bully in?

Who was being bullied?

What grade or class is the student in that is being bullied?

What type of bullying?

Physical

Emotional/Social

Damage to Property

Online

Where did the incident take place?

At the bus stop

On the bus

Classroom

Hallway

Gym

Lunch Room

Playground

Restroom

Other

Other details:

Describe what happened with as many details as possible.

Person reporting the incident:(OPTIONAL). Please use your full name.

May we contact you for more information on this incident?

Yes

Thank you for reporting this incident. We appreciate your concern. When you click "Submit Form" this will be sent to the campus administrator.

Email a copy to

optional

Required Fields

LITTLEFIELD ELEMENTARY SCHOOL

LITTLEFIELD ELEMENTARY SCHOOL

Elementary Bully Report Form

LITTLEFIELD
ELEMENTARY SCHOOL

LITTLEFIELD
ELEMENTARY SCHOOL