KCKPS STUDENT Report Bullying / Harassment

For Student
Use Only


Select your school:
Where did the incident occur?
Date of incident:
Describe what happened: Please provide as much detail as possible
Who are you?
What is your name?
Please provide your email or phone number
	This is a safety issue, immediate assistance is needed.

All information provided will be subject to confidentiality provisions of Board of Education policies.