Directions:
The Bullying, Harassment or Intimidation Reporting Form should be used to report
alleged incidents of bullying, harassment, or intimidation that occurred during the
current school year on school property, at a school-sponsored activity or event off
school property, on a school bus, on the way to and/or from school, or through
electronic communication on or off school property. School staff will address incidents
that occur at school or have a connection or nexus back to the school setting that create
a risk of harm to other students while they are at school or interfere with the educational
environment.
If you are a student, the parent/guardian or caregiver of a student, a close adult relative
of a student, a school staff member, or a bystander and wish to report an incident of
alleged bullying, cyberbullying, harassment, or intimidation, please complete this form,
and return it to the school.You may contact the school for additional information or assistance at any time.
(Bullying, cyberbullying, harassment, and intimidation definitions are provided below.)
Definitions:
Bullying– is unwanted, demeaning behavior among students that involves a real or
perceived power imbalance. The behavior is repeated, or is highly likely to be repeated,
over time. In order to be considered bullying, the behavior must be intentional and
include: 1) An imbalance of power (students who bully use their physical, emotional,
social, or academic power to control, exclude, or harm others), and 2) Repetition (bullying
behaviors happen more than once or are highly likely to be repeated based on evidence
gathered).
Cyberbullying– is bullying that takes place over digital devices like cell phones,
computers, and tablets. Cyberbullying can occur through texting, apps, or online via
social media, forums, or gaming where people can view, participate in, or share content.
Cyberbullying includes sending, posting, or sharing negative, harmful, false, or hurtful
content about another student. It can include sharing personal or private information
about someone else causing embarrassment or humiliation.
Harassment – includes actual or perceived negative actions that offend, ridicule, or
demean another student with regard to race, ethnicity, national origin, immigration
status, family/parental or marital status, sex, sexual orientation, gender identity, gender
expression, religion, ancestry, physical attributes, socioeconomic status, physical or
mental ability, or disability.
Intimidation – is any communication or action directed against another student that
threatens or induces a sense of fear and/or inferiority. Retaliation may be considered a
form of intimidation.
This form can be completed anonymously by omitting the "Name of Person Reporting the Incident" field.
Every reported act of bullying or harassment will be investigated, and parents/guardians will be informed.
