Bullying/Harassment Reporting Form
Bullying and harassment are serious acts with severe consequences and will not be tolerated.  

This form is to report alleged harassment or bullying on school property, at a school-sponsored activity or event off school campus, on a school bus, or on the way to or from school, by phone, over text messages, or on social media in the current school year.

If you are a student victim or a friend of the student who is getting harassed or bullied and wishes to report and incident of alleged harassment or bullying, complete this form, submit it to the Dean of Discipline, or the front office. The identity of reporting students is kept confidential.  Reporting students are protected against retaliation and incidents of retaliation will be treated just as severely as bullying.

BULLYING and Harassment (as defined by the Harmony Public Schools Handbook), is considered, but not limited to, any of the following: verbal or physical harassment or threat thereof, taunting, hazing, intimidating, or any other action whereby one or more individuals deliberately single out another student for cruel, mean or humiliating treatment.

For more detailed information regarding disciplinary actions associated with bullying, please see the full handbook at the link below:
http://harmonytx.org/WebShare/DOWNLOAD_CENTER/pdf/handbooks/HPS_Student_Handbook_English.pdf


If this is an URGENT bullying matter or an EMERGENCY, please speak directly to an administrator.
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Name of student reporting incident: *
Today's date: *
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Was an adult near the incident a the time? *
If so, who was the adult?
Name of the alleged victim student? *
Date of the incident: *
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Time of the incident: *
Location of the incident: *
Name(s) of the alleged harassers/bullies causing the incident: *
Describe the incident. Be as detailed as possible: *
Do you have any screenshots, text messages, or videos of incidents? *
Is there anyone else who has knowledge of the incidents? *
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