Speak Up to Stop Bullying
Aldine ISD Report Form

Aldine ISD encourages students to eliminate all types of bullying in our schools and community. Students should immediately report bullying when it is observed or experienced so that school personnel may take appropriate action. Students, parents, staff, and community members who learn of a bullying incident are asked to report it as soon as possible.

Reports may be made by completing and submitting this form. Reports may also be made by directly contacting any campus administrator or district administrator. Eliminating bullying behavior is everyone's responsibility, and your involvement is appreciated.

Please select the campus referenced in this incident *
Aldine High School Aldine Middle School Aldine Ninth Grade School Anderson Academy Avalos P-TECH Early College HS Black Elementary School Blanson CTE High School Bussey Elementary School Calvert Elementary School Caraway Elementary School Carmichael Elementary School Carroll Elementary School Carter Academy for PVA Carver Center Carver High School Cypresswood Elementary School Davis High School Davis Ninth Grade School de Santiago Primary School Drew Academy Dunn Elementary School Eckert Elementary School Eisenhower High School Eisenhower Ninth Grade School Ermel Elementary School Escamilla Elementary School Francis Elementary School G.A.P. Center Garcia Middle School Garcia-Leza Primary School Goodman Elementary School Grantham Academy for Engineering Gray Elementary School Greenspoint Elementary School Griggs Primary School Hall Success Academy Hambrick Middle School Harris Elementary School Hill Elementary School Hinojosa Primary School Hoffman Middle School Houston Academy Impact Leadership Academy Johnson Elementary School Jones Elementary School Jones Middle School Jones Primary School Keeble Primary School Knippel Education Center Kujawa Elementary School Kujawa Primary School La Promesa Lane School Lewis Middle School MacArthur High School MacArthur Ninth Grade School Magrill Primary School Marcella Elementary School Mead Middle School Nimitz High School Nimitz Ninth Grade School Odom Elementary School Ogden Elementary School Oleson Elementary School Orange Grove Elementary School Plummer Middle School Raymond Elementary School Reece Academy Reed Academy For Engineering Sammons Elementary School Shotwell Middle School Smith Elementary School Spence Elementary School Stehlik Elementary School Stephens Elementary School Stovall Middle School Stovall Primary School Teague Middle School Thompson Elementary School Vardeman Primary School Victory Early College High School Vines Primary School Worsham Elementary School Young Women's Leadership Academy
Please select the date of the incident*
Information of the person bullying:
First Name:	Last Name:
Grade of person bullying
1 2 3 4 5 6 7 8 9 10 11 12 Pre-K (4 yrs) K Unknown
Information of the person being bullied:
First Name:*	Last Name:*
Grade of person being bullied
1 2 3 4 5 6 7 8 9 10 11 12 Pre-K (4 yrs) K Unknown
Name(s) of bystanders and witnesses - If unsure, type in "Do not Know" * Character Count  0 /500   Over Limit
Type of bullying*
Being left out Cyber-bullying Gossip and rumors being spread Made fun of Name calling Other Shoving or pushing Teasing Hitting or kicking Theft or property damage Threatening
Location of bullying*
At recess At the bus stop In the cafeteria In the classroom In the hall Off-campus school event On a school bus On the way to/from school Other Physical Education Restroom Restroom or locker room
Describe what happened. Give as many details as possible* Character Count  0 /500   Over Limit
List evidence of bullying (photos, text messages, internet postings, etc) Character Count  0 /500   Over Limit
Your Name (reports may be made anonymously) Character Count  0 /255   Over Limit
Your contact information (optional) Character Count  0 /255   Over Limit
Select the response that best describes you*
Student Parent Staff member Community member Other:
Submit