DEFINITION:  Bullying, harrassment, and intimidation are intentional verbal, written and/or physical conduct or an intentional electronic communication that creates a hostile educational environment by substantially interfering with a student’s educational benefit, opportunity and performance, or with a student’s physical or psychological well-being and is as follows:

• Motivated by an actual or perceived personal characteristic, including race, national origin, marital status, sex, sexual orientation, gender identity, religion, ancestry, physical attributes, socioeconomic status, familial status or physical or mental ability or disability

• Threatening or serious intimidation

• Occurs on school property, at a school activity or event or on a school bus

• Substatially disruptive to or interfering with the orderly operation of a school

• “Electronic communication” means a communication transmitted by means of an electronic device, including but not limited to telephone, cellular phone, or a computer or pager.

DIRECTIONS:    Bullying, harassment and intimidation are serious and will not be tolerated.

This is a form to report alleged bullying, harassment, or intimidation that occured on school property; at a school-sponsored activity or event off school property; on a school bus; or 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, complete this form.

Contact the school for additional information or assistance at any time. If a threat of suicide is reported, the principle/designee will inform the parent or guardian.