Sweetwater Independent School District

Every Student Every Day

Report Bullying

* Denotes a required field.

Last Name of Victim* Please Enter the LAST Name of the Student You Believe is a Victim of Bullying.

First Name of Victim* Please Enter the FIRST Name of the Student You Believe is a Victim of Bullying

Student/Victim's Campus*

Type of Bullying* Please Check All That Apply Bullying is a behavior that is a written, electronic, verbal, or physical expression that occurs on school property, at a school sponsored/related event, or in a vehicle operated by the district that has or will have the effect of physically harming a student, damaging a student's property, or places the student in reasonable fear of harm or the conduct is sufficiently severe, persistent and pervasive so that it creates an educational environment that is intimidating, threatening, or abusive. Please check any of the below items that apply to this reported situation:
Physical harm or threatening physical harm
Obtaining money or another object of value from an unwilling person or forcing an individual to act
Making ethnic racial religious or other harrassing slurs
Verbal abuse or derogatory or offensive remarks addressed to others
Damaging or vandalizing property of other students
Conduct that constitutes sexual harassment or sexual abuse
Dating violence meaning the intentional use of physical sexual verbal or emotional abuse
Ostracism
Other

Last Name of Reporter Who is making this report? (Not Required If You Wish to Remain Anonymous)

First Name of Reporter Who is making this report? (Not Required If You Wish to Remain Anonymous)

Phone Number Please provide a phone number where you can be reached (Not Required If You Wish to Remain Anonymous)

Description of Incident(s)* Please describe the bullying incident(s) that you are reporting today.

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CONTACT INFO

	info@sweetwaterisd.net
	(325) 235-8601
	(325) 235-5561
	207 Musgrove Street Sweetwater, TX 79556 Mon - Thur: 8am - 4:15pm Friday: 8am - 3:45pm Sat - Sun: Closed

It is the policy of Sweetwater ISD not to discriminate on the basis of age, race, religion, color, national origin, sex or handicap in its programs, services or activities as required by Title VI of the Civil Rights Act of 1964, as amended; Title IX of the Education Amendments of 1972; and Section 504 of the Rehabilitation Act of 1973, as amended. Inquiries regarding compliance and/or grievance procedures may be directed to the school district's Administration Building located at 207 Musgrove Street, Sweetwater Texas, or by phone at (325) 235-8601.

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