Harassment/Bullying Report - Lewiston - Altura High School - Home - Lewiston Altura ISD 857

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Bullying/Harassment Report

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This form allows you an opportunity to report concerns of harassment, bullying, or other challenges you or other students may be dealing with in school. This form has been created to help ease communication and allow us to support our students. When this form is submitted it will be sent directly to the high school principal, and addressed in a timely manner. Please feel free to contact the principal, or by phone at 523-2191. Please provide as much information as possible to help us address concerns. Information should include names of the alleged victim and those responsible, specific incidents including details of what was done or said along with dates and times. Names of witnesses or other bystanders is also helpful. You are not required to complete the contact information below, but doing so will aid in our ability to address concerns and allow us to respond to you.

Reporter's First Name:

Reporter's Last Name:

Reporter's Email:

Name of Victim(s)	*

Name(s) of alleged offenders	*

Description of Incident(s)	*

Send a copy of the completed form to this email address :

* Indicates Required fields.