Reporting a Bullying Concern in BKC

Anti Bullying Report Form

Parents and pupils are required to co-operate with any investigation and assist the school in resolving any issues and restoring, as far as is practicable, the relationships of the parties involved as quickly as possible.

Teachers take a calm, unemotional problem-solving approach when dealing with incidents of alleged bullying behaviour reported by pupils, staff or parents.

It may also be appropriate or helpful sometimes to ask those involved to write down their account of the incident(s).

Three specific Bí Cineálta questions will be considered to inform a decision as to whether bullying has taken place.

Those questions are:
1. Is the behaviour targeted at a specific student or group of students?
2. Is the behaviour intended to cause physical, social or emotional harm?
3. Is the behaviour repeated?

I have read the three questions above and this report meets those three criteria.*

YesNo

I have read the Bi Cineálta Policy (found on our website)*

YesNo

Section A Student Information

Student Name *

First NameLast Name

Year*

Tutor*

Section B Detail of Person completing this form

Name *

First NameLast Name

E-mail*

Mobile Phone Number*

Area CodePhone Number

Relationship to person being bullied

Section C Type of Bullying Behaviour

Type of Bullying Behaviour*

Where behaviour is regarded as identity-based bullying, indicate the relevant category

Location of incidents*

Names of alleged perpetrators of bullying behaviour.*

Full description of bullying behaviour and its impact.*

Details of actions taken (including the views of the student and parent/guardian in relation to this)*

To your knowledge , has the school been informed in relation to this concern up to this point. Yes/No*

Please Note: By submitting this form I accept that the school will initiate an investigation in relation to the alleged bullying.*

YesNo