Rosebud-LottIndependent School District

Skip to main content
Mobile Menu
2018 - 2019 High School Graduation will be on Friday, May 24, at 8:00 p.m.

Loading...

Editing previous response:

Please fix the highlighted areas below before submitting.

RPS BULLYING INCIDENT REPORT FORM

Repeat Infraction?*
Answer Required
Location of Incident (check all that apply)*
Answer Required

Name of Victim(s)

Name of Student(s) Bullying

Name(s) of Witnesses/Bystanders

Type of Bullying*
Answer Required
Bullying Behaviors (check all that apply)*
Answer Required
Cyber-Bullying used*
Answer Required
Result in Injury*
Answer Required
Reported to School Nurse?*
Answer Required
Reported to Police?*
Answer Required
Reported to School by (check all that apply)*
Answer Required
Physical Evidence?*
Answer Required
Confirmation Email