Directions: Bullying, harassment, or intimidation is serious and will not be tolerated. This is a form to report alleged bullying, harassment, or intimidation that occurred on school property, at a school-sponsored activity or event off of school property, on a school bus, or on the way to and/or from school in the current school year. If you are a student victim, the parent/guardian of a student victim, a close adult relative of a student victim, or a school staff member, and wish to report an incident of alleged bullying, harassment or intimidation, please complete this form.  Once complete, the results of this form will automatically be sent to the principal at the student victim’s school.

The results of this form will be monitored between the hours of 7:00am - 5:00pm during the school year.  Any reports submitted outside of these hours, or during holidays, will be investigated during the following normally scheduled school day.  Please do not use this system for issues requiring immediate assistance.  If this is an emergency requiring immediate assistance, please call 911.  Contact the school directly for additional information or assistance during posted office hours.

What Counts As Bullying?

Bullying is  any intentional and repeated  act of unwanted aggressive or demeaning behavior  involving a real or perceived power imbalance  that takes place on or off school property, in which one or more people intentionally and repeatedly cause physical or psychological harm to another person.  To be considered bullying, the conduct  must  also place a student in reasonable fear of harm or of damage to property, have the effect of substantially interfering with educational performance or school operation,  or  create a hostile, intimidating, threatening, or abusive educational environment.

The information provided on this form is considered, and will be kept, confidential.
  • Current Start
  • Reporter
  • Victim(s)
  • Witnesses
  • Offender(s)
  • Incident
  • Injury
  • Additional Info
  • Complete
The incident(s) you are reporting involve a real or perceived power imbalance.
The incident(s) you are reporting involve *repeated* physical or psychological harm.

Criteria Not Met

Based on your answers to the previous questions, your report does not meet the criteria to be submitted via the Bullying Report Form. Please refer to the bullying definition above.

However, the incident in question should still be reported and investigated. Please report the incident directly to your school administration by using the Contact Us or Anonymous Alert forms on the school website, or by calling the school directly. Use the schools listing page for contact information.

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Names of Officers, Members or Owners of Concern, Partnership, Etc.

Names of Officers, Members or Owners of Concern, Partnership, Etc.

Person of Concern 1

Persons to Contact on Matters Concerning Bids and Contracts

Person to Contact 1

Person to Contact 2


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