Form Center

2. This tip line was created to help the Police Department identify victims of bullying. As seen in recent news reports victims take extreme measures to escape the pain of bullying which ends up destroying a family. Now with social networking sites such as Facebook, Myspace, etc… cyber bullying has become an out of control issue. We hope that with this tip line we can help victims out of these types of situations. It is also important to help the bully. Why do they bully? We can help the bully identify the problem and help them get the help that they need. We understand that friends and peers may be nervous to help another for fear of repercussion from the bully. That is why this tip line is anonymous. The tip line will not ask any biographical information about the individual leaving the tip. Once a contact has been made with the victim, the tip received will be destroyed.
4. Name of Victim*
6. Address of Victim
8. City
9. State
10. Zip
12. Phone of Victim
14. Victim's School*
15. Victim's Grade*
17. Witnesses
19. Have you told a School Official and if so who?*
21. Please Describe Bullying*
23. Name of Bully*
25. Address of Bully
27. City
28. State
29. Zip
31. Phone of Bully
33. Bully's School*
34. Bully's Grade*
36. Name of Reporting Person
38. Reporting Person Email
39. Reporting Person Phone Number
Leave This Blank:


41. 1. Receive an email copy of this form.
42. Email address

    This field is not part of the form submission.

43. Submit

* indicates a required field