Number of victims
Gender of victims
Ethnicity of victims
Number of perpetrators
Gender of perpetrators
Ethnicity of perpetrator(s)
First incident recorded for perpetrator(s)
Type of Incident:
A/ Disability B/ Sexual Orientation
C/ Racial D/ Gender E/Religious Belief
What form did the Incident take?
A/ Verbal abuse B/ Refusal of co-operate
C/ Abuse of personal property D/ Physical
E/ Abuse of school property F/ Cyber
Support to victim(s)?
A/ Staff support B/ Peer group C/
Bullying Incident Monitoring Form
To complete, enter a letter or number in each box using codes attached as in example 1 below.
D/ Other agency E/None needed
Is the victim vulnerable?
Action taken with perpetrator(s)?
A/ Immediate discussion B/ SMT involved
C/ Parent/Carer Involved D/ Fixed-term
E/Permanent Exclusion F/ Other agency
G/ None needed
Did the incident involve an adult?
A/Staff B/ Parents/Carers C/ Visitors D / No
How were incidents followed up?
A/ Contact with Learning Trust
B/ Contact with the Police C/ Contact with
Social Services D/ None needed
Bullying Monitoring Form Ethnicity Codes.
When completing the bullying monitoring forms, please use the codes below when providing information about both the victim(s)
and perpetrator(s) ethnicity.
05 Traveller of Irish Heritage
07 Greek/Greek Cypriot
09 Turkish Cypriot
10 White Eastern European
11 White Western European
12 White Other
13 Gypsy Roma
14 White and Black Caribbean
15 White and Black African
16 White and Asian
17 Any Other Mixed Background
21 Any Other Asian Background
27 Sierra Leonian
30 Other Black African
31 Any Other Black Background
35 Latin/South/Central American
37 Orthodox Jewish
39 Any Other Ethnic Group
40 Information not available