E4 HOTLINE

Please use this form to report a bullying incident.

Before submitting this form, please make sure the incident is truly an act of bullying. Click here to see what bullying is and is NOT.

Grade Level:

Did you witness the bullying or were you bullied?

. Name of student that was bullied:

Date? Time:

Who did the bullying?






Please try to give us a name or nickname. Don't worry about the spelling, spell it like it sounds.

Bully's Name:

Second Bully's Name:

Other names of students involved:

Where did this happen?

Describe what happened from beginning to end:

Please give us names of witnesses or by-standers that might also have seen this besides you.

Your contact information is optional, helpful to stop bullying, and appreciated.

TCS STAFF PROMISES TO PROTECT YOU!

Do you want a teacher, school counselor, and/or principal to contact you or your parents to offer advice or follow up with the bullying incident? Check as many boxes that apply.