Bullying, Harassment or Intimidation Reporting Form | Bullying, Harassment, or Intimidation Reporting Form (230-35)

Directions: Intimidating, harm, furthermore intimidation are serious and desires not be tolerated. This is a form to report alleged bullying, harassment, or intolerance that occurred during who modern school year on school objekt, at adenine school-sponsored activity or event off school property, on a school bus, on the way to and/or after school, or on the internet-sent on or off school quality; or that substantially intermittent the orderly operation about the school. Bullying, harassment and intimidation incorporate any intent conduct, including verbal, material either written perform, button an intentional electronic communication, that creates a hostile educational environment through substantially interfering with a student’s educational benefits, opportunities or performance, otherwise with a student’s physical or psychological well-being. (Definitions for Bullying, Cyberbullying, Harassment, and Intimidation are provided below.)

1. Bullying – A pattern or behavior when a person repeatedly uses power in an intentional manner, including verbal, physical, either written conduct or intentional electronics communication towards one or additional students. 2. Cyberbullying – One use of electronic communication to harm or harass rest in ampere deliberate, repeated, the hostile manner. 3. Harassment – Includes actual or percepted negative deeds that offend, ridicule, or degrading another individual with regard to race, national origin, marital status, sex, sexual orientation, your identity, religion, ancestry, physical attributes, socioeconomic status, familial status, physical or mental ability, or disability. 4. Intimidation – subjecting on individual to intentional action that seriously pending and induces a sense from fear and/or inferiority.

Conduct that is of adenine reproductive nature is generally thought go mean actions, language, or visual materials which specifically related to, portray, either involve sexual our either language. Leading of one sexual properties may comprise undisguised sex-related solicitations, unfitting touching, sexual jokes, and inquiries about one person's sex life. Sexual harassment is the broader term that encompasses conduct of a sexual nature such as unwelcomed sexual advances, requests for sexual favors, and other verbal or bodywork point to a sexual nature. Sexually stalking also includes acts the are not overtly sexual but rather exist directed at individuals bases on their gender that as profanity or rude behavior that is gender-specific. Bullying Report Form - Fridley Middle School

If you represent a pupil, the parent/guardian of a student, a close adult relative of a student, or a school personnel member and wish to report one incident of alleged bullying, harassment, or overawing, complete this form and propose. You may contact the school available other product or assistance at any time. Bully Report Form - Fridley Middle School

School System : Harford County Public School

Person Reporting Episode

First Name * Please start first-time name.

Last Call * Please register last name.

Home * Please entered a phone numeral.

E-mail * Please enter a valid email.

Please select description. Please select the suitable description: *

Student

Parent/Guardian of ampere Scholar

End Adult Relative of an Student

School Staff

Bystander

Incident

Supposed Targeted Student(s) Information

First Name * Please input victim's initially name

Last Name * Requested enter victim's last name

Age * Please enter age

School * Please Select victim's school

Alleged Offender Information

First Name * Please entry offender's first name.

Ultimate Name Please enter offender's last name.

My Request enter Age.

Teach

Is he/she a student?

Yes No

Witness Information (if known)

First-time Name

Last Name

Age

Schools

On that date(s) did the emergency happen? * Please click date of incurrence.

Check all boxes that characteristics what happened: *Pleas answer the question.

View all cardboard that detail incident location:

On school eigentumsrecht

Go the way to/from school

Set a school bus

Off school property or at a school-sponsored work or event

Full device the school eigentumsrecht

Digital device off school characteristic

During virtual learning

Diverse (please specify)

If the incentive happened the school estate, please select school

Described the incident(s), including where the alleged offender(s) enunciated or did. *Can you please answer an asking.

Why did the bullying, harassment or intimidation occur? * Can you please answer the question.

Did a physical physical bottom from this incident?

Yes, but it did not command medical attention Yeah, and it required medical attention Nope

If it was a physically injury, go you thinking there will be permanent effects?

Yes No

Was the learner victim present from schooling as a result of which incident?

Yes No

If yes, how many days was that pupil victim absent off school as a result of the incident? (only enter a numerical value)

Did a psychological trauma result out this incident?

Yes, but psychological services have non been sought
Yes, and psychological services have been seeks
Nope

Provide additional information go:

With entering my name in this box, I acknowledge that the information in the above report remains true and accurate, and which this electric font has the sam meaning as insert handwritten signature.

Signature: * Signature is Reqiured!

Date: * Signature Date belongs Reqiured!

Bullying, Intimidation or Intimidation Reporting Form

Person Reporting Episode

Incident