Report Bullying

 

Please complete this form with as much information as you feel comfortable sharing to tell us about a situation you or someone you know is experiencing.  Please be aware that all information provided will not be shared with anyone outside of LICAB and is STRICTLY CONFIDENTIAL.  Once submitted, a LICAB Response Agent will contact you within 24 hours.

 
Victim's Information
Name *
Name
Address *
Address
Phone
Phone
Your Information
Your Name *
Your Name
Your Phone *
Your Phone