Harassment Report Form
Bloomington Public Schools maintains a firm policy prohibiting all forms of harassment. Everyone is to be treated with respect and dignity. Harassment by any student, teacher, administrator or other school personnel which creates an intimidating environment will not be tolerated under any circumstances.

Only use this form to report issues relating to racism or harassment.

The District will respect the privacy of the complaint, the individual(s) against whom the complaint is filed and the witness as much as possible, consistent with the District's legal obligations to investigate, to take appropriate action, and to conform with any discovery or disclosure obligations.

Your name and phone number (optional but helpful). Please understand, without providing your contact information it may be difficult to pursue this report.
Your answer
I am a: *
Describe what happened: Include information on the harasser, victim and any witnesses/bystanders. The more detail you provide, the better. *
Your answer
Location (check all that apply) *
Time and date the incident occurred *
Your answer
Have you told anyone else about this incident? If so, who? (optional)
Your answer
Addition information (optional)
Your answer
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