CSD Report of Bullying Form
This form allows you to anonymously report any behavior you see that may appear as bullying. This form will be received by the CSD School Counselors or CES/CMS/CHS Principals.

Definition of Bullying: Bullying is unwanted, aggressive behavior that involves a real or perceived power imbalance. The behavior is repeated, or has the potential to be repeated, over time.

In order to be considered bullying, the behavior must be aggressive and include:

-An Imbalance of Power: Kids who bully use their power—such as physical strength, access to embarrassing information, or popularity—to control or harm others.

-Repetition: Bullying behaviors happen more than once or have the potential to happen more than once.

-Bullying includes actions such as making threats, spreading rumors, attacking someone physically or verbally, and excluding someone from a group on purpose.
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Email *
Name of reporter (First and Last) *
Name of student(s) who is believed to be bullying: *
Name of student(s) who is believed to be the victim of bullying: *
Description: please describe the situation to the best of your ability (what happened, where and when it happened): * *
Have you reported this incident/behavior to anyone prior to this? check all that apply * *
Required
A student who intentionally makes a false claim, offers false statements, or refuses to cooperate with District investigation regarding bullying shall be subject to appropriate disciplinary action.  The district prohibits retaliation (I.e. threats, rumor spreading, ostracism, assault, destruction of property, etc.) against any person who makes a report of bullying in good faith, serves as a witness, or participates in an investigation.   *
CES, CMS, or CHS? *
Additional information if needed: *
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