Bullying/Teen Dating Violence Form

Any student or parent/caregiver can report a suspected act of bullying, harassment, intimidation, or dating violence to any school employee by completing the Report of Suspected Bullying Behaviors or Teen Dating Violence Form. This form may be turned in directly to a school administrator or to a teacher or staff member who will submit the form to a school administrator who will follow up on the report.  Mean-spirited behavior can seriously impact the ability of a person to feel safe and comfortable at school. Any act of bullying or threatening and intimidating behavior will not be tolerated.  All incidents reported will be fully investigated, but not every incident will result in school discipline, depending on the specific facts of each case.

Bullying means an act that is direct or indirect and severe, persistent or pervasive, which:

(A) causes physical or emotional harm to an individual,

(B) places an individual in reasonable fear of physical or emotional harm, or

(C) infringes on the rights or opportunities of an individual at school.

Bullying shall include, but not be limited to, a written, verbal or electronic communication, or physical act or gesture-based on any actual or perceived differentiating characteristic, such as race, color, religion, ancestry, national origin, gender, sexual orientation, gender identity or expression, socioeconomic status, academic status, physical appearance, or physical, mental, developmental or sensory disability, or by association with an individual or group who has or is perceived to have one or more of such characteristics.

Dating Violence means any act of physical, emotional or sexual abuse, including stalking, harassment and threatening that occurs between two students who are currently in or who have recently been in a dating relationship.

Click here for the Report Suspected Bullying or Teen Dating Violence Form
Reporters using this form may choose to remain anonymous.

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