Help Box Form:
____________________________________________________________________________________
Name___________________ Grade___________________________
How long have you been bullied?___________________________________________________________________________________________________________________________________________________________________________________________________________________.
Why have you been bullied?__________________________________________________________________________________________________.
___ ___
Is anyone informed that you are being bullied? yes /__/ no /__/
How have you been bullied
___ ___ ___ ___
/__/ Physically /__/ Taunting /__/ Threatening /__/ Other
Please Explain___________________________________________________________________________________________________________________________________________________________.
Bully Busters will try to address your issue as soon as possible!
__________________________________________________________________________________
This is a draft of the form that a student may fill out.
No comments:
Post a Comment